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NPI Code Detail

MEDICARE: AMY JOAN KEEN FNP-BC

MEDICARE: AMY JOAN KEEN FNP-BC
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
1363LF0000XFamily Nurse Practitioner4704299710MI

General Provider Information

NPI Number : 1770267593
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY JOAN KEEN FNP-BC
Provider Business Mailing Address
First Line : 10223 E CHERRY BEND RD
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-7304
Country : US
Telephone Number : 231-218-9787
Fax Number :
Provider Business Practice Location Address
First Line : 10223 E CHERRY BEND RD
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-7304
Country : US
Telephone Number : 231-929-7933
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2023
Last Update Date : 05/07/2025

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Directions to “ AMY JOAN KEEN FNP-BC” Practice Location

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