Provider Demographics
NPI:1134900475
Name:SAPP, JULIE ELIZABETH (FNP-BC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ELIZABETH
Last Name:SAPP
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:E
Other - Last Name:CARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1711 RIFLE RDG SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-4878
Mailing Address - Country:US
Mailing Address - Phone:912-687-1772
Mailing Address - Fax:
Practice Address - Street 1:16741 HIGHWAY 67 STE A
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-2529
Practice Address - Country:US
Practice Address - Phone:912-623-2391
Practice Address - Fax:912-623-2396
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-12
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN188621363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner