Provider Demographics
NPI:1073135430
Name:KEENAN, OLIVIA ANN (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:ANN
Last Name:KEENAN
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7825 WOODSTONE LN
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66217-9622
Mailing Address - Country:US
Mailing Address - Phone:785-640-8818
Mailing Address - Fax:
Practice Address - Street 1:7825 WOODSTONE LN
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66217-9622
Practice Address - Country:US
Practice Address - Phone:785-640-8818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-78921-052363L00000X
KS13-111822-052163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WP0200XNursing Service ProvidersRegistered NursePediatrics