Provider Demographics
NPI:1356574933
Name:DANIEL, JULIA FABRYCY (MS, FNP-C)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:FABRYCY
Last Name:DANIEL
Suffix:
Gender:F
Credentials:MS, FNP-C
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Mailing Address - Street 1:165 BLUE RIDGE OVERLOOK
Mailing Address - Street 2:
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-4431
Mailing Address - Country:US
Mailing Address - Phone:706-946-5608
Mailing Address - Fax:706-374-7628
Practice Address - Street 1:134 ANSLEY DR STE 700
Practice Address - Street 2:
Practice Address - City:DAHLONEGA
Practice Address - State:GA
Practice Address - Zip Code:30533-1641
Practice Address - Country:US
Practice Address - Phone:706-701-5001
Practice Address - Fax:706-701-5002
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2022-09-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN169909363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003132118DMedicaid
GAMD2091700OtherDEA REGISTRATION
GARN169909OtherNP LICENSE