| Doctor Name: | KATHLEEN ANNETTE KEOGH |
| NPI Number: | 1013067610 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, CNP |
| License Number: | R117190-9 |
| Business Practice Address: | 1055 Westgate Dr Saint Paul, MN - 551141065 |
| Business Phone Number: | 6516359173 |
| Business Fax Number: | 6122627989 |
| Mailing Address: | 16183 Tahinka Pl Nw, PRIOR LAKE |
| State: | MN |
| Postal Code: | 553721850 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/12/2007 |
| NPI Last Update Date: | 04/29/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | R117190-9 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |