Organization
FAMILIA FIRST HEALTH NFP
Active
Other names
Familia First Health
Organization subpart
No
Provider details
NPI number
Authorized official
CARRIE KEENAN PA-C (COO)
(217) 637-1310
Entity
Organization
Contact information
Practice address
1401 S STATE ST, SUITE B, CHAMPAIGN, IL 61820
(217) 721-5080
Mailing address
PO BOX 2403, CHAMPAIGN, IL 61825
(772) 559-5878
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
01/23/2023
Last updated
07/22/2024
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