Individual
LISA KEENAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
180 PARK AVE, PORTLAND, ME 04102-2957
(207) 874-2141
Mailing address
105 MITCHELL RD, SOUTH PORTLAND, ME 04106-4824
(207) 518-3067
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN30815
ME
Other
Enumeration date
02/28/2023
Last updated
02/28/2023
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