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General NPI Number Information
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NPI Number | 1174209126
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Entity Type | Individual
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Provider Name | CHRISTINE ELIZABETH KEENAN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/26/2023
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | 11221 GALLERIA AVE STE 101
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City | RALEIGH
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State | NC
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Zip | 27614-8137
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Country | US
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Telephone | 919-562-9410
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Fax | 919-562-9425
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Provider Business Mailing Address
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Address Line | 10321 SABLEWOOD DR UNIT 119
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City | RALEIGH
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State | NC
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Zip | 27617-7914
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Country | US
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Telephone | 978-270-1301
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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 | 5018322
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License Number State | NC
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