Provider Demographics
NPI:1164556734
Name:STRONG, JULIA R (CRNP-PMH)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:R
Last Name:STRONG
Suffix:
Gender:F
Credentials:CRNP-PMH
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 BANJO LN
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21617-1002
Mailing Address - Country:US
Mailing Address - Phone:410-758-2211
Mailing Address - Fax:410-758-0698
Practice Address - Street 1:120 BANJO LN
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:MD
Practice Address - Zip Code:21617-1002
Practice Address - Country:US
Practice Address - Phone:410-758-2211
Practice Address - Fax:410-758-0698
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR057236363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD419509400Medicaid