| Doctor Name: | KEALIE J.A.M. HANSEN AGUIRRE |
| NPI Number: | 1023400934 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | APN.0991729-NP |
| Business Practice Address: | 514 Mary Esther Cut Off Nw Fort Walton Beach, FL - 325484025 |
| Business Phone Number: | 8502268550 |
| Business Fax Number: | |
| Mailing Address: | 514 Mary Esther Cut Off Nw, FORT WALTON BEACH |
| State: | FL |
| Postal Code: | 325484025 |
| Phone Number: | 8502268550 |
| Fax Number: | |
| NPI Enumeration Date: | 03/02/2015 |
| NPI Last Update Date: | 08/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | APN.0991729-NP |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |