Provider Demographics
NPI:1851607113
Name:KEENEY, LINDSAY FRANK (RD, LD, CD, CNSC)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:FRANK
Last Name:KEENEY
Suffix:
Gender:F
Credentials:RD, LD, CD, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8837 N IROQUOIS RD
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-1712
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5261 N PORT WASHINGTON RD STE 201
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53217-4903
Practice Address - Country:US
Practice Address - Phone:206-948-8810
Practice Address - Fax:503-893-3038
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2932133V00000X
WI3185-29133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2932OtherDIETETIC LICENSURE
WI3185-29OtherCERTIFIED DIETITIAN