Provider Demographics
NPI:1346256146
Name:KEEFE-CANETTI, MARJORIE BERNICE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MS
First Name:MARJORIE
Middle Name:BERNICE
Last Name:KEEFE-CANETTI
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
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Mailing Address - Street 1:6 BUTTERFIELD ROAD
Mailing Address - Street 2:POTTER BUILDING
Mailing Address - City:KINGSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02881
Mailing Address - Country:US
Mailing Address - Phone:401-874-4758
Mailing Address - Fax:401-874-2586
Practice Address - Street 1:6 BUTTERFIELD ROAD
Practice Address - Street 2:POTTER BUILDING
Practice Address - City:KINGSTON
Practice Address - State:RI
Practice Address - Zip Code:02881
Practice Address - Country:US
Practice Address - Phone:401-874-4758
Practice Address - Fax:401-874-2586
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RI25688363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily