Provider Demographics
NPI:1760994719
Name:KEENAN, NOREEN
Entity Type:Individual
Prefix:
First Name:NOREEN
Middle Name:
Last Name:KEENAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:TAPPAN
Mailing Address - State:NY
Mailing Address - Zip Code:10983-2107
Mailing Address - Country:US
Mailing Address - Phone:646-596-6705
Mailing Address - Fax:
Practice Address - Street 1:99 CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:TAPPAN
Practice Address - State:NY
Practice Address - Zip Code:10983-2107
Practice Address - Country:US
Practice Address - Phone:646-596-6705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY516045-1163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool