Individual
LISA KAY KEOWN
Active
Individual
LISA KAY KEOWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
209011058
IL
367500000X
Certified Registered Nurse Anesthetist
24283
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
28097300A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001100047
ANTHEM PROVIDER NUMBER
IN
01
—
000001664800
ANTHEM PTAN
IN
01
—
1102387917
ANTHEM PTAN
IN
05
—
300005321
—
IN
01
—
Q00372317
RAILROAD PTAN
IN
Enumeration date
12/03/2013
Last updated
07/22/2026
Update your record
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