Provider Demographics
NPI:1568445583
Name:VERNOLD, JULIE BETH (FNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:BETH
Last Name:VERNOLD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:WALTON
Mailing Address - State:NY
Mailing Address - Zip Code:13856-1218
Mailing Address - Country:US
Mailing Address - Phone:607-865-6541
Mailing Address - Fax:607-865-9164
Practice Address - Street 1:130 NORTH ST.
Practice Address - Street 2:
Practice Address - City:WALTON
Practice Address - State:NY
Practice Address - Zip Code:13856
Practice Address - Country:US
Practice Address - Phone:607-865-6541
Practice Address - Fax:607-865-6541
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3332241363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0E56510Medicare ID - Type Unspecified
P24509Medicare UPIN