Provider Demographics
NPI:1447739859
Name:KEENAN, RYAN PATRICK (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:PATRICK
Last Name:KEENAN
Suffix:
Gender:M
Credentials:DNP, APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:74 BATTERSON PARK RD
Mailing Address - Street 2:STE 107
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2565
Mailing Address - Country:US
Mailing Address - Phone:860-549-8276
Mailing Address - Fax:860-244-1075
Practice Address - Street 1:31 SEYMOUR ST
Practice Address - Street 2:STE 100
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-5521
Practice Address - Country:US
Practice Address - Phone:860-549-8276
Practice Address - Fax:860-247-3803
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT7670208600000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No208600000XAllopathic & Osteopathic PhysiciansSurgery