Individual
RYAN KEENAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
267 GRANT ST, BRIDGEPORT, CT 06610-2870
(203) 384-3000
Mailing address
132 STONEWALL DR, HAMDEN, CT 06518-1123
(203) 605-0152
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
12.008970
CT
Other
Enumeration date
07/22/2020
Last updated
01/30/2022
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