Provider Demographics
NPI:1063983914
Name:STALLINGS, JULIA MAY (CRNP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:MAY
Last Name:STALLINGS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:MAY
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 S PACA ST FL 7
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1642
Mailing Address - Country:US
Mailing Address - Phone:410-328-5842
Mailing Address - Fax:410-328-2750
Practice Address - Street 1:419 W REDWOOD ST STE 360
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-7024
Practice Address - Country:US
Practice Address - Phone:410-328-5842
Practice Address - Fax:410-328-0717
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR190175163W00000X
MDF02190642363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD965045800Medicaid