Individual
MRS. KEENYA ANDERSON STATEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1701 SUNSET AVE STE 105C, ROCKY MOUNT, NC 27804
(252) 969-0432
(888) 977-1275
Mailing address
1701 SUNSET AVE STE 105C, ROCKY MOUNT, NC 27804-4344
(252) 969-0432
(888) 977-1275
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5006213
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
5006213
NC
363LP2300X
Primary Care Nurse Practitioner
5006213
NC
Other
Enumeration date
05/31/2013
Last updated
08/30/2018
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