Provider Demographics
NPI:1366442782
Name:BLOCKER, JULIA (ARNP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:BLOCKER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 HESTER LN
Mailing Address - Street 2:
Mailing Address - City:TAZEWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37879-5088
Mailing Address - Country:US
Mailing Address - Phone:423-851-4594
Mailing Address - Fax:423-851-4595
Practice Address - Street 1:150 HESTER LN
Practice Address - Street 2:
Practice Address - City:TAZEWELL
Practice Address - State:TN
Practice Address - Zip Code:37879-5088
Practice Address - Country:US
Practice Address - Phone:423-851-4594
Practice Address - Fax:423-851-4595
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1068963363LP2300X
TN15508363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000349810OtherBLUE CROSS OF KY
KY0797501Medicaid
KYP00004755OtherRAIL ROAD MEDICARE
P65118Medicare UPIN
KY0797501Medicaid