Provider Demographics
NPI:1215584198
Name:SEWELL, JULIE B (NP-C)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:B
Last Name:SEWELL
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:B
Other - Last Name:SEWELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:JULIE B SEWELL NP-C
Mailing Address - Street 1:3800 S OCEAN DR STE 209
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33019-2915
Mailing Address - Country:US
Mailing Address - Phone:800-226-8874
Mailing Address - Fax:877-366-4776
Practice Address - Street 1:40 TECHNOLOGY PKWY S STE 300
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-2924
Practice Address - Country:US
Practice Address - Phone:800-226-8874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-24
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN127340363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner