Provider Demographics
NPI:1346954914
Name:SIFUENTES, JULIE ANNETTE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNETTE
Last Name:SIFUENTES
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 1:1426 28TH AVE N
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77590-4183
Mailing Address - Country:US
Mailing Address - Phone:409-392-8576
Mailing Address - Fax:770-723-8697
Practice Address - Street 1:1426 28TH AVE N
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77590-4183
Practice Address - Country:US
Practice Address - Phone:409-392-8576
Practice Address - Fax:770-723-8697
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX589942163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management