Provider Demographics
NPI:1619220357
Name:JULIEN, JOEZETTE DENISE
Entity type:Individual
Prefix:
First Name:JOEZETTE
Middle Name:DENISE
Last Name:JULIEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MARITIME EXPEDITIONARY SECURITY SQUADRON THREE MEDICAL
Mailing Address - Street 2:NOLF IB BLDG 169 PO BOX 357140
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:92135
Mailing Address - Country:US
Mailing Address - Phone:619-437-9384
Mailing Address - Fax:
Practice Address - Street 1:357140
Practice Address - Street 2:MARITIME EXPEDITIONARY SECURITY SQUADRON THREE MEDICAL
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:92135-7140
Practice Address - Country:US
Practice Address - Phone:619-437-9384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman