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General NPI Number Information
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NPI Number | 1609046143
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Entity Type | Individual
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Provider Name | ERIN MULLANEY KEANE RN, PPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/11/2008
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 2200 WHITNEY AVE STE 240
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City | HAMDEN
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State | CT
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Zip | 06518-3602
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Country | US
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Telephone | 203-287-5400
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Fax | 203-381-3001
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Provider Business Mailing Address
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Address Line | 2200 WHITNEY AVE STE 240
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City | HAMDEN
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State | CT
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Zip | 06518-3602
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Country | US
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Telephone | 203-287-5400
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Fax | 203-281-3001
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 12.009460
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License Number State | CT
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