Provider Demographics
NPI:1033661665
Name:KEENAN, ERIN ELIZABETH (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:ELIZABETH
Last Name:KEENAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 MANNS DR
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-1561
Mailing Address - Country:US
Mailing Address - Phone:781-421-3299
Mailing Address - Fax:
Practice Address - Street 1:103 MANNS DR
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-1561
Practice Address - Country:US
Practice Address - Phone:781-421-3299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN253647363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health