Provider Demographics
NPI:1679916142
Name:KEATING, PATRICK J (CRNA)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:J
Last Name:KEATING
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Gender:M
Credentials:CRNA
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Mailing Address - Street 1:480 MAPLE ST
Mailing Address - Street 2:SUITE C233A
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-4065
Mailing Address - Country:US
Mailing Address - Phone:978-304-8690
Mailing Address - Fax:978-304-8697
Practice Address - Street 1:480 MAPLE ST
Practice Address - Street 2:SUITE C233A
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-4065
Practice Address - Country:US
Practice Address - Phone:978-304-8690
Practice Address - Fax:978-304-8697
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
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Provider Licenses
StateLicense IDTaxonomies
MA2262634367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered