Individual provider · Type 1 NPI

Sara Elizabeth Wallace-Keeshen, FNP-BC

Primary Care Nurse Practitioner · Philadelphia, PA

NPI number 1407540602 Active

Practice location

2144 Cecil B Moore Ave
Philadelphia, PA 19121-4014

Call (215) 320-6187 Map

Mailing address

2650 Agate St
Philadelphia, PA 19125-2302

Specialties and licenses

TaxonomyCodeLicense
Primary Care Nurse Practitioner Primary 363LP2300XSP027631 (PA)

Primary Care Nurse Practitioner: Definition to come...

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About NPI 1407540602

Sara Elizabeth Wallace-Keeshen, FNP-BC's National Provider Identifier is 1407540602, issued on Jun 8, 2023. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Philadelphia, PA. The record was last updated on Jun 8, 2023.