Provider Demographics
NPI:1891419933
Name:TAYLOR, JULIA M (FNP)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:M
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 ORCHARD ST APT 7
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-3036
Mailing Address - Country:US
Mailing Address - Phone:617-909-4527
Mailing Address - Fax:
Practice Address - Street 1:37 BROADWAY
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-5552
Practice Address - Country:US
Practice Address - Phone:781-641-0100
Practice Address - Fax:781-744-7132
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2322136207Q00000X, 363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MARN2322136OtherCERTIFIED NP