Provider Demographics
NPI:1073022380
Name:JACQUES, JULIA (ARNP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:JACQUES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 SE 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-4921
Mailing Address - Country:US
Mailing Address - Phone:561-704-7994
Mailing Address - Fax:
Practice Address - Street 1:505 SE 6TH AVE
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-4921
Practice Address - Country:US
Practice Address - Phone:561-736-8806
Practice Address - Fax:561-736-3384
Is Sole Proprietor?:No
Enumeration Date:2017-09-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9324388207R00000X, 363LP2300X
FLRN9324388363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily