Provider Demographics
NPI:1356717474
Name:WILLEY, JULIE ANN (CRNP)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:WILLEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MISS
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:VINCENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:4820 UNIVERSITY DR NW
Mailing Address - Street 2:STE 19
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35816-1867
Mailing Address - Country:US
Mailing Address - Phone:256-429-9441
Mailing Address - Fax:256-721-0069
Practice Address - Street 1:4820 UNIVERSITY DR NW
Practice Address - Street 2:STE 19
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35816-1867
Practice Address - Country:US
Practice Address - Phone:256-429-9441
Practice Address - Fax:256-721-0069
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-131325363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily