Provider Demographics
NPI:1144986498
Name:JANINA KEAN ASSOCIATES LLC
Entity type:Organization
Organization Name:JANINA KEAN ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:JANINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-397-5032
Mailing Address - Street 1:PO BOX 1278
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28093-1278
Mailing Address - Country:US
Mailing Address - Phone:727-800-2332
Mailing Address - Fax:727-800-2333
Practice Address - Street 1:70 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:CT
Practice Address - Zip Code:06069-2074
Practice Address - Country:US
Practice Address - Phone:860-383-8364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-11
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty