| NPI | 1134694615 |
|---|---|
| Former Name | SHANNON ELIZABETH KEENAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: WA AP6089775) |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2023-03-08 |