Individual
MRS. SUSAN ANN KEENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
120 S JEFFERSON AVE, MESA, AZ 85208-1018
(480) 472-8704
(480) 472-8724
Mailing address
2236 S PATTERSON, MESA, AZ 85202-6645
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN047247
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
579766
—
AZ
Enumeration date
03/29/2007
Last updated
07/08/2007
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