Provider Demographics
NPI:1568185502
Name:CRISMAN, JULIANNA (DNP-FNP)
Entity Type:Individual
Prefix:
First Name:JULIANNA
Middle Name:
Last Name:CRISMAN
Suffix:
Gender:F
Credentials:DNP-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 HORSLEY PL
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:WA
Mailing Address - Zip Code:98611-9526
Mailing Address - Country:US
Mailing Address - Phone:360-751-2576
Mailing Address - Fax:
Practice Address - Street 1:156 HORSLEY PL
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:WA
Practice Address - Zip Code:98611-9526
Practice Address - Country:US
Practice Address - Phone:360-751-2576
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00136783163W00000X
WAAP61386229363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner