Provider Demographics
NPI:1114193083
Name:KEEN, JENNIFER LOUISE (APN)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:LOUISE
Last Name:KEEN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2999 IMPERIAL DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63303-1221
Mailing Address - Country:US
Mailing Address - Phone:314-750-0435
Mailing Address - Fax:
Practice Address - Street 1:6 JUNGERMANN CIR
Practice Address - Street 2:SUITE 209
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1621
Practice Address - Country:US
Practice Address - Phone:636-916-9080
Practice Address - Fax:636-916-9332
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOANP141151363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health