# MS. JUDIANNE KEIGHTLY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1861895955
- **Gender:** F
- **Credential:** CRNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | AC002004 | MD | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | AC002004 | MD | — |
| 363LP2300X | Primary Care Nurse Practitioner | SP013644 | PA | — |

## Other

- **Enumeration date:** 10/02/2014
- **Last updated:** 07/31/2018