Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 2019022919 | MO |
NPI | 1023570694 |
---|---|
Provider Name | Kristen Keeley |
First Address | Omaha, NE 68124-2353 |
Second Address | Omaha, NE 68124-2353 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2019 |
Last Update Date | 08/01/2021 |