Provider Demographics
NPI:1912454828
Name:KEELY, ADRIENNE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:ADRIENNE
Middle Name:
Last Name:KEELY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 STONEGATE DR STE 130
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HLS
Mailing Address - State:AL
Mailing Address - Zip Code:35242-2541
Mailing Address - Country:US
Mailing Address - Phone:205-977-9876
Mailing Address - Fax:205-977-9976
Practice Address - Street 1:1940 STONEGATE DR STE 130
Practice Address - Street 2:
Practice Address - City:VESTAVIA HLS
Practice Address - State:AL
Practice Address - Zip Code:35242
Practice Address - Country:US
Practice Address - Phone:205-977-9876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-143648363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily