Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 30431 | AZ |
NPI | 1144244807 |
---|---|
Provider Name | Laine E Keahey |
First Address | Chandler, AZ 85224 |
Second Address | Chandler, AZ 85224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 27/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H81030 | (02) |