Individual
JENNIFER LYNN VAN KEULEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3301 W GANDY BLVD, TAMPA, FL 33611-2931
(813) 925-1903
Mailing address
1512 E 12TH AVE UNIT 372, TAMPA, FL 33605-3578
(763) 360-0855
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/11/2019
Last updated
05/25/2022
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