MEDICARE: MS. PERRIN KEENER CSFA

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	246ZC0007X	Surgical Assistant	0136001071	VA

General Provider Information

NPI Number	:	1568325348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PERRIN KEENER CSFA

Provider Business Mailing Address
First Line	:	244 BAYHILL DR
Second Line	:
City	:	SMITHFIELD
State	:	NC
Zip	:	27577-9408
Country	:	US
Telephone Number	:	828-332-1939
Fax Number	:

Provider Business Practice Location Address
First Line	:	3000 COLISEUM DR
Second Line	:
City	:	HAMPTON
State	:	VA
Zip	:	23666-5963
Country	:	US
Telephone Number	:	757-736-1000
Fax Number	:

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

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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