Most Relevant Information
Provider Data
| NPI Number: | 1003235748 |
| Provider Name: | JACQUELYN KEEGAN NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0200X |
| Specialty: | Nurse Practitioner |
| License Number: | 22462 |
Most Important Dates
| Enumeration Date: | 04/09/2014 |
| Last Updated: | 06/15/2015 |
Provider Practice Location
4650 W SUNSET BLVD # 54
LOS ANGELES
CA
900276062
Practice Location Phone/Fax
| Phone: | 3233614141 |
| Fax: |
Provider Mailing Location
4650 W SUNSET BLVD # 54
LOS ANGELES
CA
900276062
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |