| NPI | 1871600775 |
|---|---|
| Former Name | NICOLE R KEENE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL ARNP9351504) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY9448) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2020-09-17 |