Provider Demographics
NPI:1760727317
Name:KEARNEY, JULIE (ARNP-C)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:KEARNEY
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 N ORANGE AVE
Mailing Address - Street 2:SUITE 411
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-4644
Mailing Address - Country:US
Mailing Address - Phone:407-478-0517
Mailing Address - Fax:407-646-7370
Practice Address - Street 1:2501 N ORANGE AVE
Practice Address - Street 2:SUITE 411
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-4644
Practice Address - Country:US
Practice Address - Phone:407-478-0517
Practice Address - Fax:407-646-7370
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-10
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2155472363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily