Provider Demographics
NPI:1922249572
Name:SANZ, JULIE F (ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:F
Last Name:SANZ
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4502A N. CHARLES ST.
Mailing Address - Street 2:SHS
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210
Mailing Address - Country:US
Mailing Address - Phone:410-617-5030
Mailing Address - Fax:
Practice Address - Street 1:4502A N. CHARLES ST.
Practice Address - Street 2:SHS
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21210
Practice Address - Country:US
Practice Address - Phone:410-617-5030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-11
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR153291363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD417453400Medicaid
MD417453400Medicaid