Provider Demographics
NPI:1811573926
Name:SHUBERT, JULIE L (CRNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:L
Last Name:SHUBERT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:306 PEMBROOK AVE
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3413
Mailing Address - Country:US
Mailing Address - Phone:856-986-3225
Mailing Address - Fax:
Practice Address - Street 1:7500 CENTRAL AVE STE 205
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-2432
Practice Address - Country:US
Practice Address - Phone:215-728-7711
Practice Address - Fax:215-725-2795
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01007300363LP0200X
PASP021766363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics