Provider Demographics
NPI:1326226713
Name:KEEN, BRANDE LYNN (KCSA)
Entity Type:Individual
Prefix:MRS
First Name:BRANDE
Middle Name:LYNN
Last Name:KEEN
Suffix:
Gender:F
Credentials:KCSA
Other - Prefix:MRS
Other - First Name:BRANDE
Other - Middle Name:LYNN
Other - Last Name:HARDSAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 E LIBERTY ST STE 800
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1428
Mailing Address - Country:US
Mailing Address - Phone:502-540-3341
Mailing Address - Fax:502-540-3393
Practice Address - Street 1:7801 RED SKY DR NE
Practice Address - Street 2:
Practice Address - City:LANESVILLE
Practice Address - State:IN
Practice Address - Zip Code:47136-8782
Practice Address - Country:US
Practice Address - Phone:812-736-7743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYSA171246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant