Provider Demographics
NPI:1073122941
Name:EARLS, JULIE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:EARLS
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 1:324 MEADOWSIDE RD APT A
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-4390
Mailing Address - Country:US
Mailing Address - Phone:203-610-3863
Mailing Address - Fax:
Practice Address - Street 1:999 SILVER LN FL 3
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-5343
Practice Address - Country:US
Practice Address - Phone:203-380-5270
Practice Address - Fax:203-380-5282
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT10046363LF0000X
CT127900163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WX0200XNursing Service ProvidersRegistered NurseOncology