Provider Demographics
NPI:1528174828
Name:ELAM, JULIE FAWN (FNP-BC, MSN, RN)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:FAWN
Last Name:ELAM
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Gender:F
Credentials:FNP-BC, MSN, RN
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Mailing Address - Street 1:1015 E 32ND ST
Mailing Address - Street 2:PLAZA SUITE 411
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-2707
Mailing Address - Country:US
Mailing Address - Phone:512-544-0278
Mailing Address - Fax:512-544-0279
Practice Address - Street 1:1015 E 32ND ST
Practice Address - Street 2:PLAZA SUITE 411
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-2707
Practice Address - Country:US
Practice Address - Phone:512-544-0278
Practice Address - Fax:512-544-0279
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2014-06-22
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Provider Licenses
StateLicense IDTaxonomies
KY42367163W00000X, 363L00000X
PASP009362363LF0000X
PARN582105163W00000X
TX823501363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner