Provider Demographics
NPI:1245230234
Name:KEEFE, MARCY L (FNP)
Entity Type:Individual
Prefix:
First Name:MARCY
Middle Name:L
Last Name:KEEFE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 660599
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0599
Mailing Address - Country:US
Mailing Address - Phone:214-590-4105
Mailing Address - Fax:214-590-4162
Practice Address - Street 1:5000 HARRY HINES BLVD
Practice Address - Street 2:HOMES
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7721
Practice Address - Country:US
Practice Address - Phone:214-590-0153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-30
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX619947363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86N657Medicare ID - Type Unspecified00968R
TXP44701Medicare UPIN