Provider Demographics
NPI:1033665773
Name:MCANDREW, JULIA TATUM (MSN, MPH, FNP-BC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:TATUM
Last Name:MCANDREW
Suffix:
Gender:F
Credentials:MSN, MPH, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 TUFTS ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-2711
Mailing Address - Country:US
Mailing Address - Phone:857-238-1100
Mailing Address - Fax:857-238-1170
Practice Address - Street 1:15 TUFTS ST
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:MA
Practice Address - Zip Code:02129-2711
Practice Address - Country:US
Practice Address - Phone:587-238-1100
Practice Address - Fax:857-238-1170
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN651596163W00000X
NY716343163W00000X
NJ26NR17632400163W00000X
NYF340931-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
WI331943Medicare Oscar/Certification
WI331946Medicare Oscar/Certification
WI331947Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification
NY00695941Medicaid
WI331058Medicare Oscar/Certification
WI331978Medicare Oscar/Certification
WI331009Medicare Oscar/Certification
WI331043Medicare Oscar/Certification
WI331945Medicare Oscar/Certification
WI331944Medicare Oscar/Certification
WI331952Medicare Oscar/Certification