Individual
PETER KEENAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
14554 LEE RD, CHANTILLY, VA 20151-1775
(602) 650-1212
Mailing address
14554 LEE RD, CHANTILLY, VA 20151-1775
(602) 650-1212
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
0001307449
VA
163WA2000X
Administrator Registered Nurse
0001307449
VA
Other
Enumeration date
12/02/2021
Last updated
12/02/2021
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