Provider Demographics
NPI:1891734323
Name:PAUL, JULIE ANN (CNP, CMP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:PAUL
Suffix:
Gender:F
Credentials:CNP, CMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 OAKLAND ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-5323
Mailing Address - Country:US
Mailing Address - Phone:864-336-2731
Mailing Address - Fax:833-740-3387
Practice Address - Street 1:300 BAKER AVE STE 300
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2124
Practice Address - Country:US
Practice Address - Phone:864-336-2731
Practice Address - Fax:833-740-3387
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN258056363L00000X, 367A00000X, 363LP0808X
MA258056367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife