Provider Demographics
NPI:1376964452
Name:TACARDON, JULIANA (DNP FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JULIANA
Middle Name:
Last Name:TACARDON
Suffix:
Gender:F
Credentials:DNP FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 RALPH PL
Mailing Address - Street 2:STE 112
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-4408
Mailing Address - Country:US
Mailing Address - Phone:718-954-2202
Mailing Address - Fax:
Practice Address - Street 1:11 RALPH PL
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-4401
Practice Address - Country:US
Practice Address - Phone:718-954-2202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-17
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY640481163W00000X
NY344068363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse