Healthcare Provider Details

I. General information

NPI: 1194901181
Provider Name (Legal Business Name): ANGELA HORNE KEENE N. P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2008
Last Update Date: 05/01/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HEALTH PARK DR SUITE 100
GARNER NC
27529-4679
US

IV. Provider business mailing address

200 HEALTH PARK DR SUITE 100
GARNER NC
27529-4679
US

V. Phone/Fax

Practice location:
  • Phone: 919-773-1223
  • Fax: 919-773-1955
Mailing address:
  • Phone: 919-773-1223
  • Fax: 919-773-1955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201876
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: