Provider Demographics
NPI:1326551086
Name:COELHO LONGO, JULIANNE RENEE (CNM, RN)
Entity type:Individual
Prefix:MRS
First Name:JULIANNE
Middle Name:RENEE
Last Name:COELHO LONGO
Suffix:
Gender:F
Credentials:CNM, RN
Other - Prefix:
Other - First Name:JULIANNE
Other - Middle Name:RENEE
Other - Last Name:COELHO LONGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:JULIANNE COELHO
Mailing Address - Street 1:21219 TOLLHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-9709
Mailing Address - Country:US
Mailing Address - Phone:559-259-9121
Mailing Address - Fax:
Practice Address - Street 1:263 S WEST ST
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-3411
Practice Address - Country:US
Practice Address - Phone:877-960-3426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-15
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
367A00000X
CA235924367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife