Provider Demographics
NPI:1710733654
Name:FREDIANI, JULIA L
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:L
Last Name:FREDIANI
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 1:1961 ROLLING BROOK LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89519-8325
Mailing Address - Country:US
Mailing Address - Phone:775-240-0271
Mailing Address - Fax:
Practice Address - Street 1:1961 ROLLING BROOK LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89519-8325
Practice Address - Country:US
Practice Address - Phone:775-240-0271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant