Provider Demographics
NPI:1740229210
Name:O'KEEFE, SUZANNE P (CRNP)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:P
Last Name:O'KEEFE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:520 UPPER CHESAPEAKE DR
Mailing Address - Street 2:SUITE 312 (CCC)
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4339
Mailing Address - Country:US
Mailing Address - Phone:443-643-2273
Mailing Address - Fax:443-643-1545
Practice Address - Street 1:520 UPPER CHESAPEAKE DR
Practice Address - Street 2:SUITE 312 (CCC)
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4339
Practice Address - Country:US
Practice Address - Phone:443-643-2273
Practice Address - Fax:443-643-1545
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR122814363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD383502200Medicaid
P07016Medicare UPIN
MD383502200Medicaid