Provider Demographics
NPI:1063700995
Name:SACHARKO, JULIE (APRN)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:SACHARKO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 N MAIN ST STE 310
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-4993
Mailing Address - Country:US
Mailing Address - Phone:860-920-4979
Mailing Address - Fax:833-471-4212
Practice Address - Street 1:225 N MAIN ST STE 310
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-4993
Practice Address - Country:US
Practice Address - Phone:860-920-4979
Practice Address - Fax:833-471-4212
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTE55652163WM0705X
CT4784363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4784OtherAPRN
CTE55652OtherLICENSE