Provider Demographics
NPI:1619158508
Name:SMITH, JULIA K (APN)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:K
Last Name:SMITH
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 JORDAN DR
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-3852
Mailing Address - Country:US
Mailing Address - Phone:912-536-6386
Mailing Address - Fax:912-478-1679
Practice Address - Street 1:1406 JORDAN DR
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-3852
Practice Address - Country:US
Practice Address - Phone:912-839-4508
Practice Address - Fax:912-871-1679
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN066835 NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily