Provider Demographics
NPI:1548596794
Name:KEEGAN, RICHARD DAYTON (FNP)
Entity Type:Individual
Prefix:PROF
First Name:RICHARD
Middle Name:DAYTON
Last Name:KEEGAN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6335 BRANDO LOOP
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3763
Mailing Address - Country:US
Mailing Address - Phone:916-723-8018
Mailing Address - Fax:
Practice Address - Street 1:1820 J ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-3010
Practice Address - Country:US
Practice Address - Phone:916-313-8411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19008363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily