Provider Demographics
NPI:1528331774
Name:NUTTER, JULIA MOSES (CRNP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:MOSES
Last Name:NUTTER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:MICHELE
Other - Last Name:MOSES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:291 CARTER DR STE B
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-5845
Mailing Address - Country:US
Mailing Address - Phone:844-365-2202
Mailing Address - Fax:844-558-1878
Practice Address - Street 1:291 CARTER DR STE B
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-5845
Practice Address - Country:US
Practice Address - Phone:844-365-2202
Practice Address - Fax:844-558-1878
Is Sole Proprietor?:No
Enumeration Date:2012-02-20
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0001275363L00000X, 363LF0000X
MDR165102363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD238495Y2BOtherMEDICARE
MD0524441 00Medicaid
DE250719365Medicaid
DE250719369Medicaid
DE250721122Medicaid
DE250719303Medicaid