Provider Demographics
NPI:1235158676
Name:GASTON, JULIE C (RN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:C
Last Name:GASTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 N PEACOCK AVE
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32347-2117
Mailing Address - Country:US
Mailing Address - Phone:850-584-5087
Mailing Address - Fax:850-584-8653
Practice Address - Street 1:1215 N PEACOCK AVE
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:FL
Practice Address - Zip Code:32347-2117
Practice Address - Country:US
Practice Address - Phone:850-584-5087
Practice Address - Fax:850-584-8653
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9210327163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health