Provider Demographics
NPI:1205872330
Name:KEENER, ALTHEA (MD)
Entity type:Individual
Prefix:
First Name:ALTHEA
Middle Name:
Last Name:KEENER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALTHEA
Other - Middle Name:
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:304 N WATER ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3374
Mailing Address - Country:US
Mailing Address - Phone:717-299-6371
Mailing Address - Fax:717-945-1587
Practice Address - Street 1:304 N WATER ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-3374
Practice Address - Country:US
Practice Address - Phone:717-299-6372
Practice Address - Fax:717-945-1584
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD051160L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA31195OtherHEALTH PARTNERS
PA54819OtherHEALTHAMERICA
PA7091635OtherAETNA-NON HMO
PAP002759OtherGATEWAY HEALTHPLAN
PA1100849OtherKEYSTONE MERCY
PA50055971OtherCAPITAL BLUE CROSS
PA000000127166OtherUNISON HEALTHPLAN
PA000000149538OtherUNISON HEALTHPLAN
PA000816293OtherHIGHMARK BLUE SHIELD
PA001561231 0001Medicaid
PA1100849OtherAMERIHEALTH MERCY
PA50055971OtherKEYSTONE HEALTH PLAN CENTRAL
PA50069824OtherCAPITAL BLUE CROSS
PA0845709000OtherINDEPENDENCE BLUE CROSS
PA54819OtherHEALTHAMERICA
PA816293Medicare PIN