Provider Demographics
NPI:1902587942
Name:OATES, JULIANNE ROSE (CRNA)
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:ROSE
Last Name:OATES
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JULIANNE
Other - Middle Name:ROSE
Other - Last Name:WALTON-RANTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:109 CYPRESS BAY DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-9660
Mailing Address - Country:US
Mailing Address - Phone:631-374-3126
Mailing Address - Fax:
Practice Address - Street 1:100 BREWSTER BLVD
Practice Address - Street 2:
Practice Address - City:CAMP LEJEUNE
Practice Address - State:NC
Practice Address - Zip Code:28547-2575
Practice Address - Country:US
Practice Address - Phone:910-450-4791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7210367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered