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Individual

MR. LEWIS WESLEY KEEN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSN CRNA

Contact information

Practice address
960 J K AVENT DR, GRENADA, MS 38901-5230
(662) 227-7375
Mailing address
867 HAILE RD, GORE SPRINGS, MS 38929-9549
(662) 226-9889
(662) 229-9889

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R640557
MS

Other

Enumeration date
12/26/2006
Last updated
07/08/2007
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