Provider Demographics
NPI:1750869541
Name:KEENEY, CHRISTEN (FNP)
Entity type:Individual
Prefix:
First Name:CHRISTEN
Middle Name:
Last Name:KEENEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 SUGAREE TRL
Mailing Address - Street 2:
Mailing Address - City:LOLO
Mailing Address - State:MT
Mailing Address - Zip Code:59847-9449
Mailing Address - Country:US
Mailing Address - Phone:757-620-2308
Mailing Address - Fax:
Practice Address - Street 1:7800 SUGAREE TRL
Practice Address - Street 2:
Practice Address - City:LOLO
Practice Address - State:MT
Practice Address - Zip Code:59847-9449
Practice Address - Country:US
Practice Address - Phone:757-620-2308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-131599363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily