Provider Demographics
NPI:1962503854
Name:FOLLETT, JULIE ANNE (APRN)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:FOLLETT
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 1:20 NEW HAMPSHIRE DR
Mailing Address - Street 2:D6
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-1167
Mailing Address - Country:US
Mailing Address - Phone:860-665-0039
Mailing Address - Fax:
Practice Address - Street 1:1268 MAIN ST
Practice Address - Street 2:101
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-3038
Practice Address - Country:US
Practice Address - Phone:860-665-0039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002401364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health