Provider Demographics
NPI:1417297342
Name:DAUENHAUER, JULIA WALKER (FNP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:WALKER
Last Name:DAUENHAUER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 COMBEL ST
Mailing Address - Street 2:
Mailing Address - City:WAVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39576-3123
Mailing Address - Country:US
Mailing Address - Phone:228-342-7777
Mailing Address - Fax:
Practice Address - Street 1:919 COMBEL ST
Practice Address - Street 2:
Practice Address - City:WAVELAND
Practice Address - State:MS
Practice Address - Zip Code:39576-3123
Practice Address - Country:US
Practice Address - Phone:228-342-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LATAP003041363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily