Provider Demographics
NPI:1831572908
Name:KEAHEY, WHITNEY (FNP)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:
Last Name:KEAHEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:WHITNEY
Other - Middle Name:
Other - Last Name:GUERRERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:484 COLLINS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:LA
Mailing Address - Zip Code:71418-3388
Mailing Address - Country:US
Mailing Address - Phone:318-649-5300
Mailing Address - Fax:318-649-0052
Practice Address - Street 1:484 COLLINS RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:LA
Practice Address - Zip Code:71418-3388
Practice Address - Country:US
Practice Address - Phone:318-649-5300
Practice Address - Fax:318-649-0052
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-07
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08430363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2400746Medicaid