Provider Demographics
NPI:1265987309
Name:O'KEEFE, KATELYNN ADELLA (PA)
Entity type:Individual
Prefix:MISS
First Name:KATELYNN
Middle Name:ADELLA
Last Name:O'KEEFE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:1360 PINECREST DR
Mailing Address - Street 2:
Mailing Address - City:FERNDALE
Mailing Address - State:MI
Mailing Address - Zip Code:48220-1608
Mailing Address - Country:US
Mailing Address - Phone:906-361-6655
Mailing Address - Fax:
Practice Address - Street 1:6071 W OUTER DR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-2624
Practice Address - Country:US
Practice Address - Phone:313-966-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical