Provider Demographics
NPI:1205055043
Name:SMITH, JULIE M (RN, APNC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:SMITH
Suffix:
Gender:F
Credentials:RN, APNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 BORDEN ST
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4424
Mailing Address - Country:US
Mailing Address - Phone:732-741-9546
Mailing Address - Fax:
Practice Address - Street 1:655 SHREWSBURY AVE
Practice Address - Street 2:SUITE 212
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4179
Practice Address - Country:US
Practice Address - Phone:732-613-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNNO68679363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health