Provider Demographics
NPI:1073225470
Name:MINOGUE, JULIA KATHLEEN (RN, RWP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:KATHLEEN
Last Name:MINOGUE
Suffix:
Gender:F
Credentials:RN, RWP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GALES POINT RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01944-1443
Mailing Address - Country:US
Mailing Address - Phone:617-571-7945
Mailing Address - Fax:
Practice Address - Street 1:5 GALES POINT RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01944-1443
Practice Address - Country:US
Practice Address - Phone:617-571-7945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-16
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2320715163WN1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN1003XNursing Service ProvidersRegistered NurseNutrition Support