Provider Demographics
NPI:1609754027
Name:FIELDSTONE HEALTHCARE, LLC
Entity type:Organization
Organization Name:FIELDSTONE HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:KEEN
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:985-320-1846
Mailing Address - Street 1:2252 TOWER DR STE 108155
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-5764
Mailing Address - Country:US
Mailing Address - Phone:985-320-1846
Mailing Address - Fax:
Practice Address - Street 1:2252 TOWER DR STE 108155
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-5764
Practice Address - Country:US
Practice Address - Phone:985-320-1846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care