Provider Demographics
NPI:1477501807
Name:KEEN, LISA A (AUD, FAAA)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:A
Last Name:KEEN
Suffix:
Gender:F
Credentials:AUD, FAAA
Other - Prefix:MISS
Other - First Name:LISA
Other - Middle Name:A
Other - Last Name:STURGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18 QUAIL RIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331
Mailing Address - Country:US
Mailing Address - Phone:717-633-7660
Mailing Address - Fax:
Practice Address - Street 1:1776 S QUEEN ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-4628
Practice Address - Country:US
Practice Address - Phone:717-845-6321
Practice Address - Fax:717-845-6320
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT-000719-L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAAT-000719-LOtherPA STATE LICENSE
PA001649813 0002Medicaid
PAAT-000719-LOtherPA STATE LICENSE
PAR55159Medicare UPIN