Provider Demographics
NPI:1841208642
Name:HARDING, JULAINE B (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:JULAINE
Middle Name:B
Last Name:HARDING
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 1:5525 RESEARCH PARK DR FL 4
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4873
Mailing Address - Country:US
Mailing Address - Phone:301-572-8340
Mailing Address - Fax:301-572-8403
Practice Address - Street 1:3110 GRACEFIELD RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-1820
Practice Address - Country:US
Practice Address - Phone:301-572-8340
Practice Address - Fax:301-572-8403
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR112633363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD648871400Medicaid
MD0627437-00Medicaid
MD648871400Medicaid
DC011799D28Medicare ID - Type UnspecifiedDC METRO MEDICARE NUMBER
MD543M848FMedicare ID - Type UnspecifiedMARYLAND MEDICARE NUMBER
MDP59303Medicare UPIN