Provider Demographics
NPI:1962009449
Name:SANCARRANCO, JULIA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:SANCARRANCO
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 WEST ST.
Mailing Address - Street 2:SUITE 200 #311
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401
Mailing Address - Country:US
Mailing Address - Phone:321-750-7699
Mailing Address - Fax:
Practice Address - Street 1:3093 BEVERLY LN UNIT A
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-3433
Practice Address - Country:US
Practice Address - Phone:321-750-7699
Practice Address - Fax:410-600-3939
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDACC003355208VP0000X
MDAC003355363LP2300X
MDAC007079363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care