Provider Demographics
NPI:1821865882
Name:WHITEHEAD, JULIANNA G (APRN)
Entity Type:Individual
Prefix:
First Name:JULIANNA
Middle Name:G
Last Name:WHITEHEAD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16215 TOMAHAWK ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-4820
Mailing Address - Country:US
Mailing Address - Phone:727-857-3893
Mailing Address - Fax:
Practice Address - Street 1:16215 TOMAHAWK ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-4820
Practice Address - Country:US
Practice Address - Phone:727-857-3893
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-08
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11029938363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily