Provider Demographics
NPI:1194184523
Name:QUAGRAINE, JULIANA EFUA (NP)
Entity Type:Individual
Prefix:MS
First Name:JULIANA
Middle Name:EFUA
Last Name:QUAGRAINE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:JULIANA
Other - Middle Name:EFUA
Other - Last Name:QUAGRAINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-343-9800
Mailing Address - Fax:704-347-2011
Practice Address - Street 1:125 QUEENS RD STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-3578
Practice Address - Country:US
Practice Address - Phone:704-343-9800
Practice Address - Fax:704-343-9800
Is Sole Proprietor?:No
Enumeration Date:2016-02-12
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5008372363LA2100X
NC500372363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care