Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | VT982 | VT |
NPI | 1831226588 |
---|---|
Provider Name | Dr. Maureen (molly) Ann Keefe |
First Address | Saint Albans, VT 05478-1551 |
Second Address | Saint Albans, VT 05478-1551 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VN1419 | (05) | VT |