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NPI Code Detail

MEDICARE: DR. SHANNON M. KEATING APRN

MEDICARE: DR. SHANNON M. KEATING APRN
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
1363LA2100XAcute Care Nurse PractitionerNP-990109CO
2363L00000XNurse PractitionerAPRN9189449FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1Y044EOTHERFLBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447239215
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHANNON M. KEATING APRN
Provider Business Mailing Address
First Line : 468 SW 15TH DR
Second Line :
City : BOCA RATON
State : FL
Zip : 33432-7220
Country : US
Telephone Number : 561-866-5427
Fax Number :
Provider Business Practice Location Address
First Line : 901 45TH ST
Second Line :
City : MANGONIA PARK
State : FL
Zip : 33407-2413
Country : US
Telephone Number : 561-882-9944
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2006
Last Update Date : 10/05/2023

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