Provider Demographics
NPI:1417456500
Name:KEENEY, COURTNEY BETH (ANP-C)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:BETH
Last Name:KEENEY
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:BETH
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6805 WASHINGTON BLVD.
Mailing Address - Street 2:
Mailing Address - City:GROVES
Mailing Address - State:TX
Mailing Address - Zip Code:77619-5931
Mailing Address - Country:US
Mailing Address - Phone:409-548-2624
Mailing Address - Fax:
Practice Address - Street 1:2875 JIMMY JOHNSON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77640-2002
Practice Address - Country:US
Practice Address - Phone:409-729-9222
Practice Address - Fax:409-729-9222
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136430363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner