Provider Demographics
NPI:1700370384
Name:O'KEEFE, JACLYN VICTORIA (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:JACLYN
Middle Name:VICTORIA
Last Name:O'KEEFE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JACLYN
Other - Middle Name:VICTORIA
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1011 LAKE HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-2513
Mailing Address - Country:US
Mailing Address - Phone:407-721-0545
Mailing Address - Fax:
Practice Address - Street 1:601 E ROLLINS ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1273
Practice Address - Country:US
Practice Address - Phone:407-303-9819
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9354533363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology