Provider Demographics
NPI:1548793623
Name:QUILLIN, JULIE ANN (NP-C)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:QUILLIN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:499 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-1807
Mailing Address - Country:US
Mailing Address - Phone:304-647-0957
Mailing Address - Fax:
Practice Address - Street 1:9016 SENECA TRL S
Practice Address - Street 2:
Practice Address - City:RONCEVERTE
Practice Address - State:WV
Practice Address - Zip Code:24970-8375
Practice Address - Country:US
Practice Address - Phone:681-318-3477
Practice Address - Fax:681-318-3479
Is Sole Proprietor?:No
Enumeration Date:2017-04-06
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV69950363LF0000X
NC5012918363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily