Provider Demographics
NPI:1205921715
Name:KEENAN, SUE M (RN)
Entity type:Individual
Prefix:
First Name:SUE
Middle Name:M
Last Name:KEENAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SCOTTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14546
Mailing Address - Country:US
Mailing Address - Phone:585-509-0166
Mailing Address - Fax:
Practice Address - Street 1:172 ALEXANDER STREET
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607
Practice Address - Country:US
Practice Address - Phone:585-423-9580
Practice Address - Fax:585-423-9488
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY259336-1163WA2000X, 163WC1500X, 163WI0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WA2000XNursing Service ProvidersRegistered NurseAdministrator
Not Answered163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Not Answered163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy