Provider Demographics
NPI:1447739974
Name:SELLERS, JULIENNE SULLIVAN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:JULIENNE
Middle Name:SULLIVAN
Last Name:SELLERS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:JULIENNE
Other - Middle Name:EDITH MARIE
Other - Last Name:SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:100 RICE MINE RD N STE B
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2375
Mailing Address - Country:US
Mailing Address - Phone:205-349-4200
Mailing Address - Fax:
Practice Address - Street 1:100 RICE MINE RD N STE 100
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-3905
Practice Address - Country:US
Practice Address - Phone:205-349-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-129379363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily