Provider Demographics
NPI:1508066937
Name:KEEGAN, ELIZABETH J (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:J
Last Name:KEEGAN
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:100 FRONT ST
Mailing Address - Street 2:WOT 12TH FLOOR
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-1425
Mailing Address - Country:US
Mailing Address - Phone:508-368-5532
Mailing Address - Fax:508-368-5530
Practice Address - Street 1:123 SUMMER ST
Practice Address - Street 2:SUITE 590 N.
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1216
Practice Address - Country:US
Practice Address - Phone:508-368-3179
Practice Address - Fax:508-368-3164
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
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Provider Licenses
StateLicense IDTaxonomies
MA2310363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant