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General NPI Number Information
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NPI Number | 1619626744
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Entity Type | Individual
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Provider Name | GINA LOUISE KEEDY FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/23/2022
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Last Update Date | 10/11/2025
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Provider Practice Location Address
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Address Line | 6015 E BROWN RD
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City | MESA
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State | AZ
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Zip | 85205-4452
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Country | US
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Telephone | 866-389-2727
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Fax |
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Provider Business Mailing Address
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Address Line | 21168 E OCOTILLO RD # 1190
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-8175
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 270200
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 270200
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License Number State | AZ
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