Individual
CARRIE ELIZABETH KEENAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
819 BLOOMINGTON RD, CHAMPAIGN, IL 61820-2101
(217) 356-1558
Mailing address
207 IRA ST, URBANA, IL 61802-2261
(217) 637-1310
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085007149
IL
Other
Enumeration date
08/04/2019
Last updated
11/22/2023
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