Provider Demographics
NPI:1184921322
Name:EVEREST, JULIANE NATASHA (PA-C)
Entity type:Individual
Prefix:MS
First Name:JULIANE
Middle Name:NATASHA
Last Name:EVEREST
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 W RIVER RD STE D
Mailing Address - Street 2:
Mailing Address - City:RUMSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07760-1436
Mailing Address - Country:US
Mailing Address - Phone:917-599-5889
Mailing Address - Fax:732-568-2257
Practice Address - Street 1:16 W RIVER RD STE D
Practice Address - Street 2:
Practice Address - City:RUMSON
Practice Address - State:NJ
Practice Address - Zip Code:07760-1436
Practice Address - Country:US
Practice Address - Phone:917-599-5889
Practice Address - Fax:732-568-2257
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-24
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00273600363AM0700X
NY014523363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant