Provider Demographics
NPI:1841759289
Name:KEEVEN, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:KEEVEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 JONES LN
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-8920
Mailing Address - Country:US
Mailing Address - Phone:574-376-0230
Mailing Address - Fax:
Practice Address - Street 1:650 JONES LN
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-8920
Practice Address - Country:US
Practice Address - Phone:574-376-0230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-15
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program