MRS. CAROL KEEN, FNP - NPI NUMBER 1033461777

Summary

Provider Name: MRS. CAROL KEEN, FNP

NPI Number: 1033461777

Clasification: Nurse Practitioner (363LF0000X)

Specialization: Family

Organization: C-HEALTH PC

Address:
48 COMMERCE DRIVE
HONAKER, VA
ZIP 24260

Phone Number: (276) 873-6876



Detailed Information

MRS. Carol Keen, FNP is a family nurse practitioner in Honaker, VA with 2 years of experience. The assigned NPI number for this provider is 1033461777 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business address is:

48 COMMERCE DRIVE
HONAKER, VA
ZIP 24260
Phone: (276) 873-6876
Fax: (276) 889-5505

The enumeration date for this NPI number is 10/4/2012 and was last updated on 10/4/2012.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 363LF0000X Nurse Practitioner Family 0024170391 VA Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 0024170391 OTHER VA LICENSURE NUMBER

NPI Record

No. Field Name Field Value
1 NPI 1033461777
2 Entity Type Code 1
3 Provider Last Name Legal Name KEEN
4 Provider First Name CAROL
5 Provider Name Prefix Text MRS.
6 Provider Credential Text FNP
7 Provider First Line Business Practice Location Address 48 COMMERCE DRIVE
8 Provider Business Practice Location Address City Name HONAKER
9 Provider Business Practice Location Address State Name VA
10 Provider Business Practice Location Address Postal Code 24260
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 2768736876
13 Provider Business Practice Location Address Fax Number 2768895505
14 Provider Enumeration Date 10/4/2012
15 Last Update Date 10/4/2012
16 Provider Gender Code F
17 Healthcare Provider Taxonomy Code 1 363LF0000X
18 Provider License Number 1 0024170391
19 Provider License Number State Code 1 VA
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Other Provider Identifier 1 0024170391
22 Other Provider Identifier Type Code 1 01
23 Other Provider Identifier State 1 VA
24 Other Provider Identifier Issuer 1 LICENSURE NUMBER
25 Is Sole Proprietor N

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This page was last updated on: 8/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.