Provider Demographics
NPI:1457663783
Name:KEEN, RIKKI (RD)
Entity Type:Individual
Prefix:
First Name:RIKKI
Middle Name:
Last Name:KEEN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23050 WHISPERING BIRCH DR
Mailing Address - Street 2:
Mailing Address - City:CHUGIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99567-5485
Mailing Address - Country:US
Mailing Address - Phone:808-345-4648
Mailing Address - Fax:907-688-1122
Practice Address - Street 1:23050 WHISPERING BIRCH DR
Practice Address - Street 2:
Practice Address - City:CHUGIAK
Practice Address - State:AK
Practice Address - Zip Code:99567-5485
Practice Address - Country:US
Practice Address - Phone:808-345-4648
Practice Address - Fax:907-688-1122
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK69133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered