Provider Demographics
NPI:1215966627
Name:RICHARDS, JULIE A (ARNP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 CROSSVILLE ST
Mailing Address - Street 2:
Mailing Address - City:CANTONMENT
Mailing Address - State:FL
Mailing Address - Zip Code:32533-6586
Mailing Address - Country:US
Mailing Address - Phone:850-478-5440
Mailing Address - Fax:850-478-5447
Practice Address - Street 1:185 CROSSVILLE ST
Practice Address - Street 2:
Practice Address - City:CANTONMENT
Practice Address - State:FL
Practice Address - Zip Code:32533-6586
Practice Address - Country:US
Practice Address - Phone:850-478-5440
Practice Address - Fax:850-478-5447
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9205656363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics