Provider Demographics
NPI:1245012996
Name:MAYNARD, JULIA (CRNP)
Entity type:Individual
Prefix:MS
First Name:JULIA
Middle Name:
Last Name:MAYNARD
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 1:8121 MADISON BLVD STE 101A
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-2082
Mailing Address - Country:US
Mailing Address - Phone:256-325-0041
Mailing Address - Fax:
Practice Address - Street 1:8121 MADISON BLVD STE 101A
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-2082
Practice Address - Country:US
Practice Address - Phone:256-325-0041
Practice Address - Fax:256-325-0042
Is Sole Proprietor?:No
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-178434363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily