Individual
MARY C KEANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN-CNP
Contact information
Practice address
1031 BELLEVUE AVE, SUITE 300, SAINT LOUIS, MO 63117-1818
(314) 647-9444
(314) 647-7317
Mailing address
PO BOX 23340, SAINT LOUIS, MO 63156-3340
(314) 647-9444
(314) 647-7317
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2006021094
MO
363L00000X
Nurse Practitioner
Primary
277001322
IL
363LF0000X
Family Nurse Practitioner
2013000128
MO
Other
Enumeration date
03/04/2013
Last updated
04/09/2026
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