Individual
MS. TAMMIE ANN KEANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4502
(616) 685-5000
Mailing address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9493
(616) 364-4200
(616) 364-7347
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704141880
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104685770
—
MI
01
—
P00255114
RAILROAD MEDICARE
MI
Enumeration date
04/26/2006
Last updated
09/17/2025
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