Provider Demographics
NPI:1952670044
Name:KEENER, BRIGITTE (OD)
Entity Type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:
Last Name:KEENER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WISCONSIN CIR STE 230
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-7005
Mailing Address - Country:US
Mailing Address - Phone:301-215-7100
Mailing Address - Fax:202-688-2857
Practice Address - Street 1:1145 19TH ST NW STE 335
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3717
Practice Address - Country:US
Practice Address - Phone:301-215-7100
Practice Address - Fax:202-688-2857
Is Sole Proprietor?:No
Enumeration Date:2011-12-20
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618003341152W00000X
DCOP2000565152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006340400Medicaid
FLGJ947YMedicare PIN