Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 2019019572 | MO |
N | 2080P0204X | Pediatric Emergency Doctor | 2019019572 | MO |
NPI | 1013368844 |
---|---|
Provider Name | Dr. Danielle Renee Keebaugh |
First Address | Saint Louis, MO 63110-1002 |
Second Address | Saint Louis, MO 63110-1002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2016 |
Last Update Date | 22/08/2019 |