Provider Demographics
NPI:1366830705
Name:GULLEY, JULIA (APN)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:GULLEY
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:ISELI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 54136
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79453-4136
Mailing Address - Country:US
Mailing Address - Phone:806-771-1386
Mailing Address - Fax:806-771-1388
Practice Address - Street 1:3708 22ND PL
Practice Address - Street 2:SUITE 1
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1351
Practice Address - Country:US
Practice Address - Phone:806-771-7412
Practice Address - Fax:806-771-7414
Is Sole Proprietor?:No
Enumeration Date:2015-01-08
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126909363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner