Provider Demographics
NPI:1417040494
Name:STREETER, JULIE ANN (RN-FNP)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:STREETER
Suffix:
Gender:F
Credentials:RN-FNP
Other - Prefix:MRS
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:VERDUZCO-STREETER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN-FNP
Mailing Address - Street 1:300 W. 80TH PLACE, SUITE A
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-7184
Mailing Address - Country:US
Mailing Address - Phone:219-791-9782
Mailing Address - Fax:219-971-9787
Practice Address - Street 1:300 W. 80TH PLACE, SUITE A
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-7184
Practice Address - Country:US
Practice Address - Phone:219-791-9782
Practice Address - Fax:219-971-9787
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28092058A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily