Provider Demographics
NPI:1083062442
Name:CROFFORD, JULIA
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:CROFFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:ANTENUCCI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11385 BAR RANCH CT
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79934-3227
Mailing Address - Country:US
Mailing Address - Phone:407-462-3136
Mailing Address - Fax:
Practice Address - Street 1:11385 BAR RANCH CT
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79934-3227
Practice Address - Country:US
Practice Address - Phone:407-462-3136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist