Provider Demographics
NPI:1871192443
Name:VERMEULEN, JULIA (RN, CNM, WHNP-BC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:VERMEULEN
Suffix:
Gender:F
Credentials:RN, CNM, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 WOOD ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02909-2146
Mailing Address - Country:US
Mailing Address - Phone:781-985-8375
Mailing Address - Fax:
Practice Address - Street 1:18 IMPERIAL PL UNIT 2D
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4642
Practice Address - Country:US
Practice Address - Phone:401-727-4800
Practice Address - Fax:401-921-6923
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-23
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
367A00000X
RICNM00189367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty