Provider Demographics
NPI:1629361134
Name:HALVORSEN, JULIE ANNE (RN)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANNE
Last Name:HALVORSEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 BROWN RD
Mailing Address - Street 2:
Mailing Address - City:OLIVEREA
Mailing Address - State:NY
Mailing Address - Zip Code:12410-5300
Mailing Address - Country:US
Mailing Address - Phone:845-254-5025
Mailing Address - Fax:
Practice Address - Street 1:71 BROWN RD
Practice Address - Street 2:
Practice Address - City:OLIVEREA
Practice Address - State:NY
Practice Address - Zip Code:12410-5300
Practice Address - Country:US
Practice Address - Phone:845-254-5025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-17
Last Update Date:2011-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6167421163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health