Provider Demographics
NPI:1518575638
Name:WHITAKER, JULIA (FNP-C)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 OLD WHITE STREET
Mailing Address - Street 2:UNIT 2
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546
Mailing Address - Country:US
Mailing Address - Phone:910-577-4977
Mailing Address - Fax:910-577-4980
Practice Address - Street 1:237 OLD WHITE STREET
Practice Address - Street 2:UNIT 2
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-2854
Practice Address - Country:US
Practice Address - Phone:910-577-4977
Practice Address - Fax:910-577-4980
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5013315363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily