Provider Demographics
NPI:1427676584
Name:LAIRD, JULIE DANIELLE (CRNP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:DANIELLE
Last Name:LAIRD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:DANIELLE
Other - Last Name:BABINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2967 ROSS CLARK CIR
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36301-1119
Mailing Address - Country:US
Mailing Address - Phone:334-305-2085
Mailing Address - Fax:
Practice Address - Street 1:2967 ROSS CLARK CIR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-1119
Practice Address - Country:US
Practice Address - Phone:334-305-2085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-119942363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL5859301OtherALDL