Individual
RANDI KEOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
480 CENTRAL AVE, PEARL HARBOR, HI 96860
(808) 471-1866
Mailing address
480 CENTRAL AVE, PEARL HARBOR, HI 96860-4908
(808) 471-1866
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
18054
HI
164W00000X
Licensed Practical Nurse
83743
TN
Other
Enumeration date
02/12/2015
Last updated
02/16/2015
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