Provider Demographics
NPI:1104146919
Name:PRICE, JULIANA M (RN)
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:M
Last Name:PRICE
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 1:806 PEBBLE BEACH DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53717-1140
Mailing Address - Country:US
Mailing Address - Phone:608-513-5053
Mailing Address - Fax:
Practice Address - Street 1:806 PEBBLE BEACH DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-1140
Practice Address - Country:US
Practice Address - Phone:608-513-5053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2010-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI160995-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse