Provider Demographics
NPI:1669473948
Name:HENNE-REESE, JULIE CHRISTINE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:CHRISTINE
Last Name:HENNE-REESE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 BANBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21617-2346
Mailing Address - Country:US
Mailing Address - Phone:667-358-0287
Mailing Address - Fax:410-304-0277
Practice Address - Street 1:129 BANBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:MD
Practice Address - Zip Code:21617-2346
Practice Address - Country:US
Practice Address - Phone:667-358-0287
Practice Address - Fax:410-304-0277
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR130914363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD100168OtherJHHC PROVIDER NUMBER
MD1970965OtherAETNA HMO
MD9326221OtherAETNA PPO
MD369040700Medicaid
MD500027792OtherRR MEDICARE
MD447062100Medicaid
MD615790-02OtherCAREFIRST MD RENDERING
MD7605-0052OtherCAREFIRST BLUECHOICE
MD369040700Medicaid