Healthcare Provider Details

I. General information

NPI: 1518067016
Provider Name (Legal Business Name): BETH A. KEENA MS, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2006
Last Update Date: 01/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 S STATE ST MATERNAL FETAL MEDICINE-BAYHEALTH MEDICAL CENTER
DOVER DE
19901-3530
US

IV. Provider business mailing address

1815 LIMESTONE RD
WILMINGTON DE
19804-4107
US

V. Phone/Fax

Practice location:
  • Phone: 302-744-6220
  • Fax: 302-744-6002
Mailing address:
  • Phone: 302-584-5198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: