Provider Demographics
NPI:1215603154
Name:BETSILL, JULIA
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:BETSILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19520 BURKE RD
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21161-9149
Mailing Address - Country:US
Mailing Address - Phone:410-588-6235
Mailing Address - Fax:
Practice Address - Street 1:9000 FRANKLIN SQUARE DR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3901
Practice Address - Country:US
Practice Address - Phone:443-777-7046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant