Provider Demographics
NPI:1083460265
Name:DUFFY, JULIA DIANE (FNP-BC)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:DIANE
Last Name:DUFFY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 PEACHTREE RD NE STE 520
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-3292
Mailing Address - Country:US
Mailing Address - Phone:716-708-7100
Mailing Address - Fax:
Practice Address - Street 1:3535 PEACHTREE RD NE STE 520
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-3292
Practice Address - Country:US
Practice Address - Phone:716-708-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN226106207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine