Provider Demographics
NPI:1730690231
Name:KEEGAN, CASEY (DNP, APN, FNP-C)
Entity type:Individual
Prefix:DR
First Name:CASEY
Middle Name:
Last Name:KEEGAN
Suffix:
Gender:F
Credentials:DNP, APN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 SPEEDWELL AVE
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-2934
Mailing Address - Country:US
Mailing Address - Phone:973-539-1364
Mailing Address - Fax:
Practice Address - Street 1:615 FRANKLIN TPKE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-1903
Practice Address - Country:US
Practice Address - Phone:201-447-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00773300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily