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General NPI Number Information
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NPI Number | 1154570844
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Entity Type | Individual
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Provider Name | BROOKE KEELEY DPM
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Gender | Female
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Dates
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Enumeration Date | 09/17/2008
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Last Update Date | 10/13/2012
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Provider Practice Location Address
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Address Line | 360 KINGSTOWN RD SUITE 106
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City | NARRAGANSETT
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State | RI
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Zip | 02882-3239
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Country | US
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Telephone | 401-782-8787
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Fax |
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Provider Business Mailing Address
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Address Line | 360 KINGSTOWN RD STE 106
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City | NARRAGANSETT
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State | RI
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Zip | 02882-3239
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Country | US
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Telephone | 484-885-8702
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 1229
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | DPM00333
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License Number State | RI
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