Provider Demographics
NPI:1942854955
Name:KEENE, JENI A (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JENI
Middle Name:A
Last Name:KEENE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:JENI
Other - Middle Name:A
Other - Last Name:CULVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:141 N HATCHER AVE
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-3107
Mailing Address - Country:US
Mailing Address - Phone:540-751-8140
Mailing Address - Fax:
Practice Address - Street 1:141 N HATCHER AVE
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-3107
Practice Address - Country:US
Practice Address - Phone:540-751-8140
Practice Address - Fax:571-200-1976
Is Sole Proprietor?:No
Enumeration Date:2019-07-29
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024177926363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1942854955Medicaid