# TAWNYA D. O'KEEFE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1104922400
- **Gender:** F
- **Credential:** NP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | NP421-A | ID | Yes |

## Other

- **Enumeration date:** 09/15/2006
- **Last updated:** 10/19/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 13429732 | MEDICARE PTAN | — |
| 01 | — | 1370136 | MEDICARE GROUP PTAN | — |
| 05 | — | 805757300 | — | ID |
| 05 | — | 8080036 | — | ID |