Individual
ELIZABETH W KEANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
850 HARRISON AVE, YACC, 3RD FLOOR, BOSTON, MA 02118-4001
(617) 638-6100
(617) 638-6179
Mailing address
720 HARRISON AVE, DOB 503, BOSTON, MA 02118-2371
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN280089
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110097630A
—
MA
Enumeration date
10/29/2008
Last updated
07/09/2014
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