Provider Demographics
NPI:1538531306
Name:DIAZ, JULIA (APRN)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:DIAZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1109
Mailing Address - Street 2:
Mailing Address - City:SULPHUR
Mailing Address - State:OK
Mailing Address - Zip Code:73086-8109
Mailing Address - Country:US
Mailing Address - Phone:580-622-4482
Mailing Address - Fax:580-297-9113
Practice Address - Street 1:2011 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:SULPHUR
Practice Address - State:OK
Practice Address - Zip Code:73086-4221
Practice Address - Country:US
Practice Address - Phone:580-622-4482
Practice Address - Fax:580-297-9113
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-20
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK90481163W00000X
OK94081363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse