Individual
JENNIFER KEENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(206) 987-2525
Mailing address
100 N MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ML60657210
WA
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
12810856-1205
UT
Other
Enumeration date
03/23/2016
Last updated
05/05/2023
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