Provider Demographics
NPI:1639834203
Name:JULIS, JACQULYN L (APRN-NP, DNP)
Entity Type:Individual
Prefix:
First Name:JACQULYN
Middle Name:L
Last Name:JULIS
Suffix:
Gender:F
Credentials:APRN-NP, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 24607
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-0607
Mailing Address - Country:US
Mailing Address - Phone:402-955-5400
Mailing Address - Fax:402-955-3674
Practice Address - Street 1:110 N 175TH ST STE 1000
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68118-3581
Practice Address - Country:US
Practice Address - Phone:402-955-8300
Practice Address - Fax:402-955-7310
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE113741363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care