Provider Demographics
NPI:1164196853
Name:KEANE, NORA KATHRYN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:KATHRYN
Last Name:KEANE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2676 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80207-3246
Mailing Address - Country:US
Mailing Address - Phone:970-412-4925
Mailing Address - Fax:
Practice Address - Street 1:190 S MAIN ST
Practice Address - Street 2:
Practice Address - City:KEENESBURG
Practice Address - State:CO
Practice Address - Zip Code:80643-5002
Practice Address - Country:US
Practice Address - Phone:303-732-4268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-05
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0996755363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily