Provider Demographics
NPI:1316503808
Name:MONTEIRO-PAI, JULIE (CRNP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:MONTEIRO-PAI
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 COUNT FLEET CT
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35756-4284
Mailing Address - Country:US
Mailing Address - Phone:256-476-6803
Mailing Address - Fax:
Practice Address - Street 1:4181 HOSPITAL DR NE STE 202
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2541
Practice Address - Country:US
Practice Address - Phone:770-385-4291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-10
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALF04190105363LF0000X
GAGAA-NP001221363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily