Provider Demographics
NPI:1104440791
Name:CUMBERS, JULIANNE (NP)
Entity type:Individual
Prefix:MRS
First Name:JULIANNE
Middle Name:
Last Name:CUMBERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 FOREST RIDGE CV
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-8055
Mailing Address - Country:US
Mailing Address - Phone:908-380-7878
Mailing Address - Fax:
Practice Address - Street 1:210 FOREST RIDGE CV
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-8055
Practice Address - Country:US
Practice Address - Phone:908-380-7878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-30
Last Update Date:2020-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3014630363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care