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General NPI Number Information
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NPI Number | 1639739717
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Entity Type | Individual
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Provider Name | ALEXANDRA MARIE KEANE MD
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Gender | Female
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Dates
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Enumeration Date | 06/19/2019
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Last Update Date | 01/30/2026
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Provider Practice Location Address
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Address Line | 2341 LIME KILN LN
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City | LOUISVILLE
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State | KY
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Zip | 40222-3460
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Country | US
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Telephone | 502-899-9979
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Fax |
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Provider Business Mailing Address
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Address Line | 2341 LIME KILN LN
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City | LOUISVILLE
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State | KY
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Zip | 40222-3460
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Country | US
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Telephone | 502-899-9979
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 2019018222
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 59796
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License Number State | KY
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