Provider Demographics
NPI:1679640890
Name:KEEN, RUTH A (CERT NURSE MIDWIFE)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:A
Last Name:KEEN
Suffix:
Gender:F
Credentials:CERT NURSE MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 STILES ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079
Mailing Address - Country:US
Mailing Address - Phone:603-898-4269
Mailing Address - Fax:603-894-4582
Practice Address - Street 1:45 STILES ROAD
Practice Address - Street 2:SUITE 101
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079
Practice Address - Country:US
Practice Address - Phone:603-898-4269
Practice Address - Fax:603-894-4582
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0433932301367A00000X
MA132446367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0357189Medicaid
NH30343666Medicaid
MACN0133OtherBCBS
NH30343666Medicaid
S32213Medicare UPIN