Individual
MRS. HEATHER DIANE KEANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN,CNOR,RNFA
Contact information
Practice address
2105 E TETON BLVD, GREEN RIVER, WY 82935-6220
(307) 262-2467
Mailing address
2105 E TETON BLVD, GREEN RIVER, WY 82935-6220
(307) 262-2467
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
16282
WY
Other
Enumeration date
06/04/2009
Last updated
06/04/2009
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