Provider Demographics
NPI:1568894418
Name:JULIANO, ALISHA ANN (LAC,, RN)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:ANN
Last Name:JULIANO
Suffix:
Gender:F
Credentials:LAC,, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 JACKSON ST
Mailing Address - Street 2:APT. A
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403-2113
Mailing Address - Country:US
Mailing Address - Phone:410-353-2805
Mailing Address - Fax:
Practice Address - Street 1:1610 WEST ST
Practice Address - Street 2:SUITE 201
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-4055
Practice Address - Country:US
Practice Address - Phone:410-353-2805
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR169435163W00000X
MDU01978171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No163W00000XNursing Service ProvidersRegistered Nurse