Provider Demographics
NPI:1588996250
Name:SMITH, JULIA NACCARATO (CRNP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:NACCARATO
Last Name:SMITH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:833 CHESTNUT STREET
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4405
Mailing Address - Country:US
Mailing Address - Phone:215-955-7190
Mailing Address - Fax:215-923-9186
Practice Address - Street 1:833 CHESTNUT STREET
Practice Address - Street 2:SUITE 301
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4405
Practice Address - Country:US
Practice Address - Phone:215-955-7190
Practice Address - Fax:215-923-9186
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN584631163W00000X
PASP010624363LF0000X
NJ26NJ00328000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1588996250Medicaid
NJ0275841Medicaid