Kathleen Annette Keogh
Nurse Practitioner - Gerontology
1055 Westgate Dr
Saint Paul
, Minnesota 55114-1065
Kathleen Annette Keogh
Nurse Practitioner - Gerontology
1055 Westgate Dr
Saint Paul
, Minnesota 55114-1065
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About
Features
Specialties
- Nurse Practitioner - Gerontology
Languages spoken
- English
Location
First Address
- Kathleen Annette Keogh
- 16183 Tahinka Pl Nw
- Prior Lake, MN
- Zip : 55372-1850
- Phone :
Second Address
- Kathleen Annette Keogh
- 1055 Westgate Dr
- Saint Paul, MN
- Zip : 55114-1065
- Fax : (612) 262-7989
- Phone : (651) 635-9173
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LG0600X | Nurse Practitioner - Gerontology | R117190-9 | MN |
National Provider Identifier
| NPI | 1013067610 |
|---|---|
| Provider Name | Kathleen Annette Keogh |
| First Address | Prior Lake, MN 55372-1850 |
| Second Address | Saint Paul, MN 55114-1065 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 12/01/2007 |
| Last Update Date | 29/04/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1027328-00 | (05) | MN |
| P69461 | (02) | MN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.