Healthcare Provider Details

I. General information

NPI: 1144986498
Provider Name (Legal Business Name): JANINA KEAN ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2021
Last Update Date: 04/22/2022
Certification Date: 04/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 N MAIN ST
SHARON CT
06069-2074
US

IV. Provider business mailing address

PO BOX 1278
LINCOLNTON NC
28093-1278
US

V. Phone/Fax

Practice location:
  • Phone: 860-383-8364
  • Fax:
Mailing address:
  • Phone: 727-800-2332
  • Fax: 727-800-2333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JANINA KEAN
Title or Position: NP
Credential:
Phone: 860-397-5032