Provider Demographics
NPI:1386229185
Name:STRZEMPKO, KEEGAN (WHNP)
Entity type:Individual
Prefix:
First Name:KEEGAN
Middle Name:
Last Name:STRZEMPKO
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:KEEGAN
Other - Middle Name:FORD
Other - Last Name:BALDWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:47 CATHEDRAL AVE
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-1901
Mailing Address - Country:US
Mailing Address - Phone:413-329-7879
Mailing Address - Fax:
Practice Address - Street 1:175 BROAD ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4026
Practice Address - Country:US
Practice Address - Phone:401-421-9620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-12
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICAPRN03862363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health