Provider Demographics
NPI:1043490857
Name:BUFORD, JULIE MARIE (WHNP, FNP)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:MARIE
Last Name:BUFORD
Suffix:
Gender:F
Credentials:WHNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 WEST MAIN STREET
Mailing Address - Street 2:SUITE E
Mailing Address - City:FREDERICKTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:63645-1111
Mailing Address - Country:US
Mailing Address - Phone:573-783-3341
Mailing Address - Fax:573-783-1096
Practice Address - Street 1:611 WEST MAIN STREET
Practice Address - Street 2:SUITE E
Practice Address - City:FREDERICKTOWN
Practice Address - State:MO
Practice Address - Zip Code:63645-1111
Practice Address - Country:US
Practice Address - Phone:573-783-3341
Practice Address - Fax:573-783-1024
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORN147013363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health