Provider Demographics
NPI:1326477696
Name:KEEFE, JOANNE (FNP)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:
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 1:30 SOMBRA DEL GALLO CIR
Mailing Address - Street 2:
Mailing Address - City:QUEMADO
Mailing Address - State:NM
Mailing Address - Zip Code:87829-7004
Mailing Address - Country:US
Mailing Address - Phone:575-773-4518
Mailing Address - Fax:
Practice Address - Street 1:8 OLD TOWN LOOP
Practice Address - Street 2:
Practice Address - City:QUEMADO
Practice Address - State:NM
Practice Address - Zip Code:87829
Practice Address - Country:US
Practice Address - Phone:575-773-4610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP02287363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily