Provider Demographics
NPI:1174630826
Name:JAMES, JULIA VERETTA (APRN-BC; FNP-C)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:VERETTA
Last Name:JAMES
Suffix:
Gender:F
Credentials:APRN-BC; FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3239
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29502-3239
Mailing Address - Country:US
Mailing Address - Phone:843-777-7487
Mailing Address - Fax:843-777-7102
Practice Address - Street 1:1040 MARLBORO WAY
Practice Address - Street 2:SUITE 1
Practice Address - City:BENNETTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29512-2494
Practice Address - Country:US
Practice Address - Phone:843-479-5890
Practice Address - Fax:843-479-3524
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2426363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP0840Medicaid
SCNP0840Medicaid