Provider Demographics
NPI:1124521984
Name:DINICE, JULIE A (RN)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:A
Last Name:DINICE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WILLIAMS WAY
Mailing Address - Street 2:
Mailing Address - City:TERRYVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06786-4800
Mailing Address - Country:US
Mailing Address - Phone:203-650-2220
Mailing Address - Fax:
Practice Address - Street 1:2 WILLIAMS WAY
Practice Address - Street 2:
Practice Address - City:TERRYVILLE
Practice Address - State:CT
Practice Address - Zip Code:06786-4800
Practice Address - Country:US
Practice Address - Phone:203-650-2220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTE52985163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn