Healthcare Provider Details

I. General information

NPI: 1790605780
Provider Name (Legal Business Name): EMILY KEEVAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 OLD SHELL RD
MOBILE AL
36607-3021
US

IV. Provider business mailing address

PO BOX 746450
ATLANTA GA
30374-6450
US

V. Phone/Fax

Practice location:
  • Phone: 251-415-1475
  • Fax: 251-415-1476
Mailing address:
  • Phone: 866-401-3057
  • Fax: 318-868-6430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1457A
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: