Provider Demographics
NPI:1083655302
Name:DUNCAN, JULIA A (NP-PP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:A
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:NP-PP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SW COLUMBIA ST STE 103
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-1175
Mailing Address - Country:US
Mailing Address - Phone:541-728-0978
Mailing Address - Fax:541-728-0979
Practice Address - Street 1:300 SW COLUMBIA ST STE 300
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-1174
Practice Address - Country:US
Practice Address - Phone:541-728-0978
Practice Address - Fax:541-728-0979
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202005262NP-PP163WP0808X, 363LP0808X
WY20367.0313363LF0000X, 364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500645337Medicaid
WY121773900Medicaid
CO63027071Medicaid