Provider Demographics
NPI:1376878181
Name:O'KEEFE, MICHAEL JOHN JR (NP-C)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOHN
Last Name:O'KEEFE
Suffix:JR
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 MDG, UNIT 3215
Mailing Address - Street 2:RAMSTEIN AB, APO AE
Mailing Address - City:APO
Mailing Address - State:AL
Mailing Address - Zip Code:09094
Mailing Address - Country:US
Mailing Address - Phone:312-479-2273
Mailing Address - Fax:
Practice Address - Street 1:86 MDG, UNIT 3215
Practice Address - Street 2:RAMSTEIN AB, APO AE 09094
Practice Address - City:APO
Practice Address - State:AL
Practice Address - Zip Code:09094
Practice Address - Country:US
Practice Address - Phone:312-479-2733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-13
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH043883-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily