Individual
MS. WENDY H KEENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
750 MAIN ST, REISTERSTOWN, MD 21136-2515
(410) 526-7800
(410) 584-1887
Mailing address
515 FAIRMOUNT AVE, STE 400, TOWSON, MD 21286-5466
(410) 494-1324
(410) 494-1361
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0003038
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN6601
R/R MEDICARE GROUP
MD
01
—
P00681528
R/R MEDICARE PIN
MD
Enumeration date
02/06/2007
Last updated
09/12/2016
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