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General NPI Number Information
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NPI Number | 1366471252
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Entity Type | Individual
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Provider Name | JOANNE M KEEFE-TOMASELLO NP
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Gender | Female
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 410 N MAIN ST
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City | SUMMERVILLE
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State | SC
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Zip | 29483-6420
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Country | US
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Telephone | 843-871-3277
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Fax | 843-871-3360
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Provider Business Mailing Address
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Address Line | PO BOX 749306
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City | ATLANTA
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State | GA
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Zip | 30374-9306
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1259
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License Number State | SC
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