Provider Demographics
NPI:1386047223
Name:TONDREAU, JULIANNE MILES (FNP)
Entity type:Individual
Prefix:DR
First Name:JULIANNE
Middle Name:MILES
Last Name:TONDREAU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JULIANNE
Other - Middle Name:MILES
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:112 WALL ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-3255
Mailing Address - Country:US
Mailing Address - Phone:919-339-1641
Mailing Address - Fax:984-464-7709
Practice Address - Street 1:112 WALL ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NC
Practice Address - Zip Code:27565-3255
Practice Address - Country:US
Practice Address - Phone:919-339-1641
Practice Address - Fax:984-464-7709
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007245207Q00000X, 208000000X, 364SF0001X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health