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Individual

MICHAEL HALE KEENE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNP

Contact information

Practice address
4760 WOODMERE BLVD, MONTGOMERY, AL 36106-3065
(334) 288-0814
(334) 288-3417
Mailing address
4760 WOODMERE BLVD, MONTGOMERY, AL 36106-3065
(334) 288-0814
(334) 288-3417

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-084635
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5782688
DRIVER LICENSE
AL
Enumeration date
11/03/2016
Last updated
11/03/2016
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