MEDICARE: MRS. KRISTY LYNN KEATING ANCP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	AP3424	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326270059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KRISTY LYNN KEATING ANCP-C

Provider Business Mailing Address
First Line	:	3709 N CAMPBELL AVE STE 201
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-1563
Country	:	US
Telephone Number	:	520-838-2122
Fax Number	:	520-838-2245

Provider Business Practice Location Address
First Line	:	1238 W ORANGE GROVE RD STE 103
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-2950
Country	:	US
Telephone Number	:	520-838-3540
Fax Number	:	520-325-3526

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2009
Last Update Date	:	11/30/2021

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