Provider Demographics
NPI:1477789303
Name:JULIAN, TERESA W (RN FNP PHD)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:W
Last Name:JULIAN
Suffix:
Gender:F
Credentials:RN FNP PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1688 GUILFORD RD
Mailing Address - Street 2:
Mailing Address - City:UPPER ARLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43221-3853
Mailing Address - Country:US
Mailing Address - Phone:614-485-0785
Mailing Address - Fax:
Practice Address - Street 1:1688 GUILFORD RD
Practice Address - Street 2:
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:43221-3853
Practice Address - Country:US
Practice Address - Phone:614-485-0785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-05
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 177812-COA1163W00000X, 163WA2000X
OHRN177812-COA1163WH0200X, 163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory