| Doctor Name: | KATHLEEN C. KEATING |
| NPI Number: | 1154583094 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DO |
| License Number: | TL45921 |
| Business Practice Address: | 785 Russell St Craig, CO - 816252019 |
| Business Phone Number: | 9708262420 |
| Business Fax Number: | 9708262429 |
| Mailing Address: | 190 E Bannock St, BOISE |
| State: | ID |
| Postal Code: | 837126241 |
| Phone Number: | 2083812222 |
| Fax Number: | 9708262429 |
| NPI Enumeration Date: | 07/01/2008 |
| NPI Last Update Date: | 02/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | TL45921 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CO |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |