Provider Demographics
NPI:1487701017
Name:STONEROAD VEDDA, JULIE DENISE (APA-C, MPAS)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:DENISE
Last Name:STONEROAD VEDDA
Suffix:
Gender:F
Credentials:APA-C, MPAS
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:DENISE
Other - Last Name:STONEROAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1444 E CORONADO RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2251
Mailing Address - Country:US
Mailing Address - Phone:602-252-3772
Mailing Address - Fax:602-267-2965
Practice Address - Street 1:5636 E MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-3455
Practice Address - Country:US
Practice Address - Phone:602-629-4363
Practice Address - Fax:602-267-2965
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1890363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical