Anne Harmon Keen, CRNP

Individual provider Active NPI Pediatric Nurse Practitioner · Greenville, AL

NPI 1609915974 · NPPES record last updated Oct 11, 2012

Key facts

NPI
1609915974
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Nurse Practitioner 363LP0200X
License
1065300 (AL)
Practice address
46 L V Stabler Dr
Greenville, AL 36037-3865
Phone
(334) 382-9760
Fax
(334) 383-9331
NPI assigned
Feb 5, 2007
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1065300ALMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Rural Health Clinics, Inc Pediatrics Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1065300 AL Yes

Addresses

Primary practice location

46 L V Stabler Dr
Greenville, AL 36037-3865

Mailing address

46 L V Stabler Dr
Greenville, AL 36037-3865
Phone (334) 382-9760

Other identifiers

IdentifierTypeStateIssuer
128423MedicaidAL
541003905MedicaidAL
051077467OtherALBC PROVIDER NO

Other providers in Greenville, AL

All providers in Greenville, AL · Pediatric Nurse Practitioner in Alabama

Sources for this page

Verify at the official NPI Registry.