Provider Demographics
NPI:1427739036
Name:MUNDT, JULIA ANNE (DNP)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ANNE
Last Name:MUNDT
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:600 RIDGELY AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1082
Mailing Address - Country:US
Mailing Address - Phone:410-573-9191
Mailing Address - Fax:410-573-5910
Practice Address - Street 1:600 RIDGELY AVE STE 110
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1082
Practice Address - Country:US
Practice Address - Phone:410-573-9191
Practice Address - Fax:410-573-5910
Is Sole Proprietor?:No
Enumeration Date:2023-07-27
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR245498363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily