Provider Demographics
NPI:1013460336
Name:CARDENAS, JULIE (RN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:CARDENAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3609 LAKERIDGE DR E
Mailing Address - Street 2:
Mailing Address - City:LAKE TAPPS
Mailing Address - State:WA
Mailing Address - Zip Code:98391-9197
Mailing Address - Country:US
Mailing Address - Phone:360-601-0080
Mailing Address - Fax:360-861-6715
Practice Address - Street 1:3609 LAKERIDGE DR E
Practice Address - Street 2:
Practice Address - City:LAKE TAPPS
Practice Address - State:WA
Practice Address - Zip Code:98391-9197
Practice Address - Country:US
Practice Address - Phone:360-601-0080
Practice Address - Fax:360-861-6715
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00093148163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health