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General NPI Number Information
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NPI Number | 1699244335
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Entity Type | Individual
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Provider Name | BENJAMIN JAMES KEENAN FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 11/23/2018
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 4500 SAN PABLO RD S
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City | JACKSONVILLE
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State | FL
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Zip | 32224-1865
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Country | US
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Telephone | 904-953-2000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 743904
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City | ATLANTA
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State | GA
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Zip | 30374-3904
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Country | US
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Telephone | 803-296-7320
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Fax | 803-296-7330
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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 | APRN11039187
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License Number State | FL
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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 | 22390
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License Number State | SC
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