| Keene Clinic | |
|
190 S Main Street Keenesburg CO 80643-0559 | |
| (303) 732-4268 | |
| (303) 732-9288 |
| Full Name | Keene Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 190 S Main Street, Keenesburg, Colorado |
| Authorized Official Name and Position | Benjamin Martinez-andujo (CEO) |
| Authorized Official Contact | 3037324268 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Keene Clinic 190 S Main Street Po Box 559 Keenesburg CO 80643-0559 Ph: (303) 732-4268 | Keene Clinic 190 S Main Street Keenesburg CO 80643-0559 Ph: (303) 732-4268 |
| NPI Number | 1205016136 |
|---|---|
| Provider Enumeration Date | 11/08/2007 |
| Last Update Date | 02/15/2011 |
| Medicare PECOS PAC ID | 9638145196 |
|---|---|
| Medicare Enrollment ID | O20040907000316 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205016136 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Benjamin Martinez-andujo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952321150 PECOS PAC ID: 4183802895 Enrollment ID: I20110919000132 |
| Provider Name | Hector Juan Brignoni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336196245 PECOS PAC ID: 5395916399 Enrollment ID: I20110923000253 |
| Provider Name | Laura Stoneberger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033538889 PECOS PAC ID: 0446510275 Enrollment ID: I20180215002317 |
| Provider Name | Vanessa Sue Burnham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104594720 PECOS PAC ID: 9133526973 Enrollment ID: I20210922000490 |
| Provider Name | Olivia Amoakowaa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508313834 PECOS PAC ID: 1557735511 Enrollment ID: I20230315001163 |
| Provider Name | Larissa Kaye Kreutzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528895851 PECOS PAC ID: 4587198957 Enrollment ID: I20241107000975 |