Provider Demographics
NPI:1699314773
Name:BRADER, JULIA MICHELLE (PA-C)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:MICHELLE
Last Name:BRADER
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:MICHELLE
Other - Last Name:WASHBURN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 604350
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-4350
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1450 MATTHEWS TOWNSHIP PKWY STE 250
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5331
Practice Address - Country:US
Practice Address - Phone:704-841-1444
Practice Address - Fax:704-849-2520
Is Sole Proprietor?:No
Enumeration Date:2020-01-06
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
NC0010-09723363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant