Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 50549 | TN |
Y | 208600000X | Surgeon | 50549 | TN |
N | 208200000X | Surgeon | MD19546 | ME |
N | 208600000X | Surgeon | MD19546 | ME |
NPI | 1003864273 |
---|---|
Provider Name | Patricia A Keefe |
First Address | Fort Riley, KS 66442-4030 |
Second Address | Fort Riley, KS 66442-4030 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 19/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002375402 | (02) | ME |
002375403 | (02) | ME |