Provider Demographics
NPI:1346833621
Name:KEEHN, DAINA CLARISSA (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:DAINA
Middle Name:CLARISSA
Last Name:KEEHN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9723 S 232ND CIR
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:NE
Mailing Address - Zip Code:68028-4340
Mailing Address - Country:US
Mailing Address - Phone:402-990-7822
Mailing Address - Fax:
Practice Address - Street 1:9723 S 232ND CIR
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:NE
Practice Address - Zip Code:68028-4340
Practice Address - Country:US
Practice Address - Phone:402-990-7822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical