Provider Demographics
NPI:1306920046
Name:DUVAL, JULIE DANIEL (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:DANIEL
Last Name:DUVAL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 602373
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2373
Mailing Address - Country:US
Mailing Address - Phone:828-651-6474
Mailing Address - Fax:
Practice Address - Street 1:53 S FRENCH BROAD AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3272
Practice Address - Country:US
Practice Address - Phone:828-258-9635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-00638363A00000X
WI7521-23363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1306920046Medicaid
NCNCS329BMedicare PIN
NCNCS329CMedicare PIN