Provider Demographics
NPI:1134341654
Name:KEHOE, PAULINE PENNELL (M AC)
Entity type:Individual
Prefix:MRS
First Name:PAULINE
Middle Name:PENNELL
Last Name:KEHOE
Suffix:
Gender:F
Credentials:M AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2239 NW 20TH CT
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-3920
Mailing Address - Country:US
Mailing Address - Phone:352-281-2742
Mailing Address - Fax:
Practice Address - Street 1:2239 NW 20TH CT
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-3920
Practice Address - Country:US
Practice Address - Phone:352-281-2742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2440171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist