Provider Demographics
NPI:1386229185
Name:STRZEMPKO, KEEGAN (RN)
Entity Type:Individual
Prefix:
First Name:KEEGAN
Middle Name:
Last Name:STRZEMPKO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KEEGAN
Other - Middle Name:FORD
Other - Last Name:BALDWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:21 1ST AVE APT 123
Mailing Address - Street 2:
Mailing Address - City:KEY LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33037-4018
Mailing Address - Country:US
Mailing Address - Phone:413-329-7879
Mailing Address - Fax:
Practice Address - Street 1:21 1ST AVE APT 123
Practice Address - Street 2:
Practice Address - City:KEY LARGO
Practice Address - State:FL
Practice Address - Zip Code:33037-4018
Practice Address - Country:US
Practice Address - Phone:413-329-7879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9527009163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse