Provider Demographics
NPI:1700236189
Name:WILSON, JULIANNE (APN)
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:WILSON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:JULIANNE
Other - Middle Name:
Other - Last Name:MONGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 STATE ROUTE 31
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5812
Mailing Address - Country:US
Mailing Address - Phone:908-782-5100
Mailing Address - Fax:
Practice Address - Street 1:121 ROUTE 31 STE 1000
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-5755
Practice Address - Country:US
Practice Address - Phone:908-237-7018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-16
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00642400363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner