Individual
STACEY KEENEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
205 WALNUT ST., ELLINGTON, MO 63638
(573) 663-2525
(573) 663-7821
Mailing address
PO BOX 763, VAN BUREN, MO 63965-0763
(573) 323-4548
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
137877
MO
Other
Enumeration date
10/17/2006
Last updated
07/08/2007
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