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Individual
SANDRA M KEAVEY
Active
Individual
SANDRA M KEAVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-03212
NC
363A00000X
Physician Assistant
5601001357
MI
363A00000X
Physician Assistant
Primary
PA60467722
WA
363AM0700X
Medical Physician Assistant
PA60467722
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-03212
STATE LICENSE
NC
01
—
N98340001
MEDICARE
MI
01
—
SK001357
STATE LICENSE
MI
Enumeration date
06/20/2005
Last updated
06/15/2022
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