Provider Demographics
NPI:1225088008
Name:KEENAN, KARA L (ARNP-C)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:L
Last Name:KEENAN
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:L
Other - Last Name:PLOGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP-C
Mailing Address - Street 1:713 W 11TH ST
Mailing Address - Street 2:
Mailing Address - City:LARNED
Mailing Address - State:KS
Mailing Address - Zip Code:67550-2055
Mailing Address - Country:US
Mailing Address - Phone:620-804-6007
Mailing Address - Fax:620-285-6195
Practice Address - Street 1:713 W 11TH ST
Practice Address - Street 2:
Practice Address - City:LARNED
Practice Address - State:KS
Practice Address - Zip Code:67550-2055
Practice Address - Country:US
Practice Address - Phone:620-804-6007
Practice Address - Fax:620-285-6195
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45342363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100428190AMedicaid
KS100428190DMedicaid
KSKA1118002Medicare PIN
KSP68519Medicare UPIN
KS160840Medicare ID - Type Unspecified
KS016852051Medicare PIN