Provider Demographics
NPI:1184850240
Name:MCBRIDE, JULIANNE JUDGE (CRNP)
Entity type:Individual
Prefix:MS
First Name:JULIANNE
Middle Name:JUDGE
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 FRANKLIN AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811-1236
Mailing Address - Country:US
Mailing Address - Phone:443-513-4222
Mailing Address - Fax:
Practice Address - Street 1:314 FRANKLIN AVE STE 103
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-1236
Practice Address - Country:US
Practice Address - Phone:443-513-4231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR149567363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD119591300Medicaid