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General NPI Number Information
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NPI Number | 1124798053
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Entity Type | Individual
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Provider Name | AMANDA LEE KEENAN CRNP
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Gender | Female
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Dates
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Enumeration Date | 09/13/2021
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 720 NORMAN DR
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City | LEBANON
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State | PA
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Zip | 17042-7481
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Country | US
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Telephone | 717-639-3230
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Fax | 717-274-1659
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Provider Business Mailing Address
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Address Line | 8100 LANCASTER AVE
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City | BETHEL
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State | PA
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Zip | 19507-9707
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Country | US
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Telephone | 717-851-1405
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP022593
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN660162
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | MK7819088
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License Number State | PA
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