Provider Demographics
NPI:1710954904
Name:KEEFE, THERESA ANN (CRNA)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:ANN
Last Name:KEEFE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7261 MERCY RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2311
Mailing Address - Country:US
Mailing Address - Phone:402-449-4847
Mailing Address - Fax:402-449-4885
Practice Address - Street 1:601 N 30TH ST
Practice Address - Street 2:SUITE 3222
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2128
Practice Address - Country:US
Practice Address - Phone:402-449-4847
Practice Address - Fax:402-449-4885
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE100351367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered