Provider Demographics
NPI:1740396654
Name:KEENER, REBECCA CHRISTINE (LPN)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:CHRISTINE
Last Name:KEENER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 PEACHTREE DR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44805-1852
Mailing Address - Country:US
Mailing Address - Phone:419-281-1045
Mailing Address - Fax:
Practice Address - Street 1:1430 PEACHTREE DR
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-1852
Practice Address - Country:US
Practice Address - Phone:419-281-1045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 063330164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse