Provider Demographics
NPI:1386316776
Name:KEANE, LAUREN (APN)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:KEANE
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 1:154 MOUNT BETHEL RD BLDG B
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5147
Mailing Address - Country:US
Mailing Address - Phone:908-755-5400
Mailing Address - Fax:
Practice Address - Street 1:154 MOUNT BETHEL RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5147
Practice Address - Country:US
Practice Address - Phone:908-755-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01209400363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner