Stacey Keeney, RN

Individual provider Active NPI Registered Nurse · Ellington, MO

NPI 1770664906 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1770664906
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
137877 (MO)
Practice address
205 Walnut St.
Ellington, MO 63638
Phone
(573) 663-2525
Fax
(573) 663-7821
NPI assigned
Oct 17, 2006
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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
137877MOMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Big Springs Medical Association Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 137877 MO Yes

Addresses

Primary practice location

205 Walnut St.
Ellington, MO 63638

Mailing address

PO Box 763
Van Buren, MO 63965-0763
Phone (573) 323-4548

Other names

  • Stacey Zimmer Former name

Other providers in Ellington, MO

All providers in Ellington, MO · Registered Nurse in Missouri

Sources for this page

Verify at the official NPI Registry.