Provider Demographics
NPI:1467870949
Name:JULIAND, ELIZABETH MALONEY (PNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MALONEY
Last Name:JULIAND
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 N MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:MA
Mailing Address - Zip Code:02067-1172
Mailing Address - Country:US
Mailing Address - Phone:781-784-0403
Mailing Address - Fax:
Practice Address - Street 1:450 N MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:MA
Practice Address - Zip Code:02067
Practice Address - Country:US
Practice Address - Phone:781-784-0403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001262139163W00000X
MARN2291761163W00000X, 363LP0200X
VA0024173168363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse