DR. JENEANE MAUREEN KELLER (NPI# 1275994725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275994725 |
| Entity Type | Individual |
| Full Name | DR. JENEANE MAUREEN KELLER |
| Credential | PMHNP |
| Practice Address |
1075 E Fort Lowell Rd Tucson AZ 85719-2159 |
| Practice Telephone | 5202021960 |
| Mailing Telephone | 5202021960 |
| Enumeration Date | 2016-03-11 |
| Last Update Date | 2016-10-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WP0808X |
Registered Nurse Specialization: Psych/Mental Health |
0001210194 | VA | Nursing Service Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
AP8905 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
2015006095 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1075 E FORT LOWELL RD |
| City | TUCSON |
| State | AZ |
| Zip Code | 85719-2159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083811665 | Herald Surya | Nurse Practitioner | 1075 E Fort Lowell Rd, Tucson, AZ 85719 | 2007-06-28 |
| 1760021042 | Maria Elena Nickel | Nurse Practitioner | 1075 E Fort Lowell Rd, Tucson, AZ 85719-2159 | 2020-01-03 |
| 1740795582 | Carolyn Marie Guajardo | Counselor | 1075 E Fort Lowell Rd, Tucson, AZ 85719-2159 | 2017-12-01 |
| 1386092690 | Julie Birns | Registered Nurse | 1075 E Fort Lowell Rd, Tucson, AZ 85719-2159 | 2016-05-26 |
| 1376931493 | Codac Health, Recovery & Wellness, Inc. | Clinic/Center | 1075 E Fort Lowell Rd, Tucson, AZ 85719-2159 | 2014-12-23 |
| 1760883821 | Genoa Healthcare, LLC | Pharmacy | 1075 E Fort Lowell Rd, Tucson, AZ 85719-2159 | 2014-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649813635 | Ishani Ravindra Deo | Psychologist | 1051 E Mabel St, Tucson, AZ 85719 | 2019-10-22 |
| 1235793100 | Jacquelyn Christine Wagner | Pediatrics | 1625 N Campbell, Tucson, AZ 85719 | 2019-04-26 |
| 1831652189 | Derek Allan Hatfield | Emergency Medicine | 1625 N Campbell Ave., Tucson, AZ 85719 | 2019-04-12 |
| 1053874305 | Travis Patrick Martin | Emergency Medicine | 1625 N. Campbell Ave, Tucson, AZ 85719 | 2019-04-12 |
| 1245793504 | Martin Cisneroz | Emergency Medicine | 1625 North Campbell Avenue, Tucson, AZ 85719 | 2019-04-12 |
| 1174086722 | Sarah Joy Ring | Emergency Medicine | 1625 N. Campbell Ave., Tucson, AZ 85719 | 2019-04-10 |
| 1790245520 | Akash M Doshi | Student in an Organized Health Care Education/Training Program | 3838 N Campbell Avenue, Bldg 2, Tuscon, AZ 85719 | 2019-03-20 |
| 1942773668 | Jeffery Roy Small | Massage Therapist | 3607 N Vine, Tucson, AZ 85719 | 2019-01-04 |
| 1114434180 | Elizabeth Irene Welch | Behavioral Analyst | 1430 E Fort Lowell Rd Ste 100, Tucson, AZ 85719 | 2017-12-29 |
| 1477076255 | Medavail Pharmacy Inc. | Pharmacy | 1430 E Fort Lowell Rd Ste 120, Tucson, AZ 85719 | 2017-07-24 |
| Find all providers in zip 85719 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164031563 | Yun Bunch | Nurse Practitioner | 3220 W Ina Rd Apt 3102, Tucson, AZ 85741-2163 | 2020-07-31 |
| 1013525534 | James Tutu Fiske I | Nurse Practitioner | 5700 E. Pima Street Suite C., Tucson, AZ 85712 | 2020-07-21 |
| 1497370258 | Summit Behavioral Health Pllc | Nurse Practitioner | 8230 E Broadway Blvd Ste E7, Tucson, AZ 85710-4002 | 2020-06-08 |
| 1811523210 | Phillip Allen Stensrud | Nurse Practitioner | 1416 E Linden St, Tucson, AZ 85719-3634 | 2020-03-17 |
| 1952948911 | Esteem Behavioral Healthcare LLC | Nurse Practitioner | 6650 N Oracle Rd Ste 110, Tucson, AZ 85704-5604 | 2019-12-09 |
| 1679115489 | Eric James Mccracken | Nurse Practitioner | 1230 South Cherrybell Stravanue, Tucson, AZ 85713 | 2019-10-14 |
| 1326583014 | Tucson Treatment Center, Inc | Nurse Practitioner | 10573 E Oakbrook St, Tucson, AZ 85747-5966 | 2017-01-04 |
| 1801266556 | Jennifer Budd | Nurse Practitioner | 2435 N. Castro Avenue, Tucson, AZ 85730 | 2015-10-06 |
| 1215303946 | Joy Kwakuyi | Nurse Practitioner | 4400 E Broadway Blvd Ste 411, Tucson, AZ 85711-3554 | 2015-08-17 |
| 1659776557 | Mahmoud Moghaddami | Nurse Practitioner | 1075 E Ft Lowell, Tucson, AZ 85749 | 2014-11-04 |
| Find all providers in TUCSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.