Provider Demographics
NPI:1205825296
Name:MURTHI, JULIANNE (NP)
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:MURTHI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JULIANNE
Other - Middle Name:
Other - Last Name:GLANCY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 42738
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21284-2738
Mailing Address - Country:US
Mailing Address - Phone:410-543-1957
Mailing Address - Fax:410-543-2951
Practice Address - Street 1:239 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-7504
Practice Address - Country:US
Practice Address - Phone:603-224-6561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH063653-23363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3095429Medicaid
NH001256402Medicare PIN