Provider Demographics
NPI:1861622912
Name:KEEGAN WOCN SERVICES, INC.
Entity type:Organization
Organization Name:KEEGAN WOCN SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:KEEGAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, WOCN
Authorized Official - Phone:952-937-9889
Mailing Address - Street 1:7060 SPRINGHILL CIR
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55346-2615
Mailing Address - Country:US
Mailing Address - Phone:952-937-9889
Mailing Address - Fax:952-937-9889
Practice Address - Street 1:7060 SPRINGHILL CIR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55346-2615
Practice Address - Country:US
Practice Address - Phone:952-937-9889
Practice Address - Fax:952-937-9889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN199925527163WE0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WE0900XNursing Service ProvidersRegistered NurseEnterostomal TherapyGroup - Single Specialty