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General NPI Number Information
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NPI Number | 1326844937
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Entity Type | Individual
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Provider Name | MARY KEENAN
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Gender | Female
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 621 N MCKINLEY ST
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City | HOBBS
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State | NM
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Zip | 88240-8256
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Country | US
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Telephone | 575-393-0755
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 770
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City | HOBBS
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State | NM
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Zip | 88241-0770
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Country | US
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Telephone |
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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 | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 57749
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License Number State | NM
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