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Individual

EILEEN F KEANE

Active
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Individual

EILEEN F KEANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PNP

Taxonomy

Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
006169
CT
363LP0200X
Pediatric Nurse Practitioner
Primary
6169
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1300709
—
MA
01
—
56780
FALLON SELECT
MA
01
—
NP9903
BCBS
MA
01
—
Y10141
BCBS-GROUP
MA
Enumeration date
08/10/2006
Last updated
11/29/2018
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