Individual
ANGELA D KEENAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(800) 879-2467
Mailing address
1008 S 17TH ST UNIT A, PHILADELPHIA, PA 19146-1902
(772) 403-3107
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
9461254
FL
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
SP027242
PA
Other
Enumeration date
03/31/2020
Last updated
03/14/2023
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