Provider Demographics
NPI:1043004039
Name:WILSON, JULIE MARIE (CRNP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE
Last Name:WILSON
Suffix:
Gender:
Credentials:CRNP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:MARIE
Other - Last Name:HOLT, BEIERSDOERFER, CHILDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:207 WOODFERN DR
Mailing Address - Street 2:
Mailing Address - City:KILLEN
Mailing Address - State:AL
Mailing Address - Zip Code:35645-6862
Mailing Address - Country:US
Mailing Address - Phone:256-762-8799
Mailing Address - Fax:
Practice Address - Street 1:207 WOODFERN DR
Practice Address - Street 2:
Practice Address - City:KILLEN
Practice Address - State:AL
Practice Address - Zip Code:35645-6862
Practice Address - Country:US
Practice Address - Phone:256-762-8799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-100891363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily