Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Pathrusim Levi Keaffaber, CNP

Individual provider Nurse Practitioner · NPI 1225993223

Pathrusim Levi Keaffaber, CNP is a Nurse Practitioner in Prestonsburg, Kentucky. Qualified in 2025, 1 year ago. Licensed in Kentucky and West Virginia.

Years since qualifying
1
Licensed in
KY, WV
In the registry since
2025
Specialties on file
2
What do these letters mean?
CNP — Certified Nurse Practitioner
A certified nurse practitioner.

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Practice location Address checks out

5000 KY-321
Prestonsburg, KY 41653
Phone: (606) 886-8511
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 4049598 (KY)
Nurse Practitioner Taxonomy 363L00000X · Licence 82693 (WV)

Record details

NPI number1225993223
Entity typeIndividual (Type 1)
GenderMale
Credentials CNP
Sole proprietorNo
NPI enumeratedDecember 22, 2025
Last updated in NPPESDecember 22, 2025
Certification dateDecember 18, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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