Healthcare Provider Details

I. General information

NPI: 1871053116
Provider Name (Legal Business Name): KATHERINE O'KEEFE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2019
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 ROOSEVELT TRL
NAPLES ME
04055-5329
US

IV. Provider business mailing address

410 ROOSEVELT TRL
NAPLES ME
04055-5329
US

V. Phone/Fax

Practice location:
  • Phone: 207-693-6106
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD29108
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: