Individual
NICOLE KEEGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
300 2ND AVE, LONG BRANCH, NJ 07740-6303
(732) 222-5200
Mailing address
PO BOX 62, LONG BRANCH, NJ 07740-0062
(908) 692-9833
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
26NJ002531100
NJ
363LF0000X
Family Nurse Practitioner
Primary
26NJ00253100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
176236YGTA
MEDICARE NOVITAS
NJ
Enumeration date
12/29/2009
Last updated
05/14/2024
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