Provider Demographics
NPI:1295496362
Name:NGUYEN, JULIA (PA-C)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 GRAND PRAIRIE PKWY FL 1
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-8979
Mailing Address - Country:US
Mailing Address - Phone:515-241-6886
Mailing Address - Fax:515-241-4057
Practice Address - Street 1:2515 GRAND PRAIRIE PKWY FL 1
Practice Address - Street 2:
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-8979
Practice Address - Country:US
Practice Address - Phone:515-241-6886
Practice Address - Fax:515-241-4057
Is Sole Proprietor?:No
Enumeration Date:2021-12-31
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA111038363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant