Provider Demographics
NPI:1639552490
Name:O'KEEFE, LAURA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:O'KEEFE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720A MEDICAL PARK DR STE 150
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-2135
Mailing Address - Country:US
Mailing Address - Phone:228-392-7429
Mailing Address - Fax:228-396-3842
Practice Address - Street 1:1720A MEDICAL PARK DR STE 150
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532
Practice Address - Country:US
Practice Address - Phone:228-990-0878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN232343363LF0000X
MS901440363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily