Provider Demographics
NPI:1407132665
Name:MOREAU, JULIE CARMEN (APRN)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:CARMEN
Last Name:MOREAU
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6422 E SPEEDWAY BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-1149
Mailing Address - Country:US
Mailing Address - Phone:520-318-3004
Mailing Address - Fax:520-318-3061
Practice Address - Street 1:6422 E SPEEDWAY BLVD STE 150
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-1149
Practice Address - Country:US
Practice Address - Phone:520-318-3004
Practice Address - Fax:520-318-3061
Is Sole Proprietor?:No
Enumeration Date:2011-11-01
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH046400-23363LC0200X
AZAP9831363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine