Individual
CAROLINA MONA KEENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP-AGACNP-BC
Contact information
Practice address
4940 HAMRICK RD, MEDFORD, OR 97502-3072
(541) 535-6239
Mailing address
931 CHEVY WAY, MEDFORD, OR 97504-4127
(541) 535-6239
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201801773NP-PP
OR
Other
Enumeration date
11/28/2017
Last updated
01/20/2020
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