Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 159071 | AK |
NPI | 1023502606 |
---|---|
Provider Name | Priya Keane |
First Address | Anchorage, AK 99501-4942 |
Second Address | Anchorage, AK 99508-4662 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2018 |
Last Update Date | 07/07/2020 |