Individual
MS. JUDITH ANN KILLEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1127 16TH AVE S, JACKSONVILLE BEACH, FL 32250
(904) 247-7778
(904) 247-9461
Mailing address
PO BOX 45443, SALT LAKE CITY, UT 84145-0443
(904) 202-1032
(904) 376-4107
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP1791762
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34436
MEDICARE GROUP #
FL
Enumeration date
03/04/2006
Last updated
12/28/2018
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