Provider Demographics
NPI:1851550289
Name:SUGARBAKER, JULIE A (ARNP)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:A
Last Name:SUGARBAKER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:28 STATE ST
Mailing Address - Street 2:SUITE 2860
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02109-1775
Mailing Address - Country:US
Mailing Address - Phone:617-903-5000
Mailing Address - Fax:617-903-5009
Practice Address - Street 1:28 STATE ST
Practice Address - Street 2:SUITE 2860
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02109-1775
Practice Address - Country:US
Practice Address - Phone:617-903-5000
Practice Address - Fax:617-903-5009
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9298407363LA2200X
CANP20779363LA2200X
MARN258752363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health