MEDICARE: JOSLYN KEENER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	1-100500	KS

General Provider Information

NPI Number	:	1184551749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSLYN KEENER

Provider Business Mailing Address
First Line	:	4107 10TH ST STE B
Second Line	:
City	:	GREAT BEND
State	:	KS
Zip	:	67530-3497
Country	:	US
Telephone Number	:	620-792-5944
Fax Number	:

Provider Business Practice Location Address
First Line	:	4107 10TH ST STE B
Second Line	:
City	:	GREAT BEND
State	:	KS
Zip	:	67530-3497
Country	:	US
Telephone Number	:	620-792-5944
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2026
Last Update Date	:	05/07/2026

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