Individual
MARY JANE KEEGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
116 E EASY ST, FORT PIERCE, FL 34982-3999
(772) 828-6075
Mailing address
116 E EASY ST, FORT PIERCE, FL 34982-3999
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN1192491
FL
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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