Individual
STACY KEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
10800 KNIGHTS RD, PHILADELPHIA, PA 19114-4200
(215) 632-7888
Mailing address
10800 KNIGHTS RD, PHILADELPHIA, PA 19114-4200
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
SPO2546
PA
Other
Enumeration date
01/26/2022
Last updated
01/26/2022
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