Provider Demographics
NPI:1689688996
Name:KEEL, EUGENIE R (RN, MSN, CRNP)
Entity Type:Individual
Prefix:MRS
First Name:EUGENIE
Middle Name:R
Last Name:KEEL
Suffix:
Gender:F
Credentials:RN, MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 EDGEWATER LN
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:MA
Mailing Address - Zip Code:02738-1204
Mailing Address - Country:US
Mailing Address - Phone:508-748-6781
Mailing Address - Fax:
Practice Address - Street 1:175 ELM ST
Practice Address - Street 2:VA PRIMARY CARE CLINIC
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-6006
Practice Address - Country:US
Practice Address - Phone:508-994-0217
Practice Address - Fax:508-994-5489
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA246402363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology