Provider Demographics
NPI:1326798398
Name:PENDER, JULIE (FNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:PENDER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SPRING OAK CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-1816
Mailing Address - Country:US
Mailing Address - Phone:850-206-8682
Mailing Address - Fax:
Practice Address - Street 1:1041 KIRKPATRICK RD STE 100
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8066
Practice Address - Country:US
Practice Address - Phone:336-538-0565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPEND-HTO2D207Q00000X
NC5015972363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine