Healthcare Provider Details

I. General information

NPI: 1801118229
Provider Name (Legal Business Name): COURTNEY LEIGH KEEN NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2010
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2869 NEW MONROE RD
BASTROP LA
71220-1429
US

IV. Provider business mailing address

130 DIANE ST
RAYVILLE LA
71269-5502
US

V. Phone/Fax

Practice location:
  • Phone: 985-320-1846
  • Fax:
Mailing address:
  • Phone: 985-320-1846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN121762
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP09315
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: