Provider Demographics
NPI:1528154648
Name:JULIEN, MAUREEN B (CRNP)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:B
Last Name:JULIEN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:
Other - Last Name:BURKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNP
Mailing Address - Street 1:3400 CIVIC CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5127
Mailing Address - Country:US
Mailing Address - Phone:215-662-6574
Mailing Address - Fax:
Practice Address - Street 1:3400 CIVIC CENTER BLVD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5127
Practice Address - Country:US
Practice Address - Phone:215-662-6574
Practice Address - Fax:215-349-5894
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007152363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAQ16849Medicare UPIN