Provider Demographics
NPI:1114644218
Name:KEENAN, AMBER (APRN)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:
Last Name:KEENAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:ORLOVSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2228 W MICHELLE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-1224
Mailing Address - Country:US
Mailing Address - Phone:972-523-6090
Mailing Address - Fax:
Practice Address - Street 1:2228 W MICHELLE DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-1224
Practice Address - Country:US
Practice Address - Phone:972-523-6090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ226851363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health