Provider Demographics
NPI:1609915974
Name:KEEN, ANNE HARMON (CRNP)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:HARMON
Last Name:KEEN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 L V STABLER DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36037-3865
Mailing Address - Country:US
Mailing Address - Phone:334-382-9760
Mailing Address - Fax:334-383-9331
Practice Address - Street 1:46 L V STABLER DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:AL
Practice Address - Zip Code:36037-3865
Practice Address - Country:US
Practice Address - Phone:334-382-9760
Practice Address - Fax:334-383-9331
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1065300363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL128423Medicaid
AL541003905Medicaid
AL051077467OtherBC PROVIDER NO