Provider Demographics
NPI:1598338238
Name:STUPKE, JULIE LYNN (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNN
Last Name:STUPKE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 RADCLIFF CIR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-2504
Mailing Address - Country:US
Mailing Address - Phone:607-745-9632
Mailing Address - Fax:
Practice Address - Street 1:8304 CREEDMOOR RD.
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-1697
Practice Address - Country:US
Practice Address - Phone:919-870-8409
Practice Address - Fax:877-622-8953
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC50146772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry