Provider Demographics
NPI:1508483231
Name:JULIANO, ELISE MARIE (CNP)
Entity Type:Individual
Prefix:
First Name:ELISE
Middle Name:MARIE
Last Name:JULIANO
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:354 MERRIMACK ST STE 1
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1755
Mailing Address - Country:US
Mailing Address - Phone:978-687-2321
Mailing Address - Fax:978-722-7287
Practice Address - Street 1:354 MERRIMACK ST STE 1
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1755
Practice Address - Country:US
Practice Address - Phone:978-687-2321
Practice Address - Fax:978-722-7287
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2301869363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily