Provider Demographics
NPI:1316548886
Name:KEEN, WHITNEY NICOLE (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:NICOLE
Last Name:KEEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:WHITNEY
Other - Middle Name:NICOLE
Other - Last Name:HORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:145 BLUE LEAF DR
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-3888
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7373 PEPPERS FERRY BLVD
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:VA
Practice Address - Zip Code:24141-8857
Practice Address - Country:US
Practice Address - Phone:540-731-4033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202215004183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist