Healthcare Provider Details

I. General information

NPI: 1164348686
Provider Name (Legal Business Name): JULIA PAIGE KEELING
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 ASHLEY AVE
CHARLESTON SC
29425-8908
US

IV. Provider business mailing address

10 WESTEDGE ST UNIT 523
CHARLESTON SC
29403-6918
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-2300
  • Fax:
Mailing address:
  • Phone: 513-478-6804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number459820
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: