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Individual

KEISHA AMIEE PERMENTER-KEENE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
576 JEFFERSON AVE, FORT EUSTIS, VA 23604-1373
(757) 914-6066
Mailing address
3212 LYTHAM CT, TOANO, VA 23168-9384
(757) 435-8751

Taxonomy

Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
0001154524
VA

Other

Enumeration date
03/06/2025
Last updated
03/06/2025
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