MEDICARE: EMMA O'KEEFE NP

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	363LW0102X	Women's Health Nurse Practitioner	233977	MA

Other Identifiers

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

General Provider Information

NPI Number	:	1972561355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMA O'KEEFE NP

Provider Business Mailing Address
First Line	:	57 BEDFORD ST
Second Line	:	STE 205
City	:	LEXINGTON
State	:	MA
Zip	:	02420-4500
Country	:	US
Telephone Number	:	781-247-0311
Fax Number	:

Provider Business Practice Location Address
First Line	:	57 BEDFORD ST
Second Line	:	STE 205
City	:	LEXINGTON
State	:	MA
Zip	:	02420-4500
Country	:	US
Telephone Number	:	781-247-0311
Fax Number	:

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

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	03/09/2010

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