Provider Demographics
NPI:1053725325
Name:KEATING, JULIE WILDING (ARNP)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:WILDING
Last Name:KEATING
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 HARBOUR PLACE DR UNIT 1114
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-6799
Mailing Address - Country:US
Mailing Address - Phone:502-836-9260
Mailing Address - Fax:
Practice Address - Street 1:2894 W BAY DR
Practice Address - Street 2:
Practice Address - City:BELLEAIR BLUFFS
Practice Address - State:FL
Practice Address - Zip Code:33770-2620
Practice Address - Country:US
Practice Address - Phone:727-518-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9277188363LP2300X
FL9277188363LP2300X
TXAP126105163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care