Provider Demographics
NPI:1801397393
Name:MCKEON, JEANNE M (OTR)
Entity Type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:M
Last Name:MCKEON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12351 GRAHAM MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-6619
Mailing Address - Country:US
Mailing Address - Phone:804-916-0075
Mailing Address - Fax:
Practice Address - Street 1:12351 GRAHAM MEADOWS DR
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-6619
Practice Address - Country:US
Practice Address - Phone:804-916-0075
Practice Address - Fax:804-916-0075
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119000403225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist