Provider Demographics
NPI:1942531934
Name:KEEL, JOAN BOOKER (CNP)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:BOOKER
Last Name:KEEL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:
Other - Last Name:BOOKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:3850 WINDERMERE PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-7033
Mailing Address - Country:US
Mailing Address - Phone:678-455-2800
Mailing Address - Fax:770-888-9998
Practice Address - Street 1:3850 WINDERMERE PKWY STE 105
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-7033
Practice Address - Country:US
Practice Address - Phone:678-455-2800
Practice Address - Fax:770-888-9998
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN192550363L00000X
TN14677363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner