Provider Demographics
NPI:1245839786
Name:PIFER, JULIE (FNP-C)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:PIFER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 STRAUGHNS MILL RD
Mailing Address - Street 2:
Mailing Address - City:PEDRICKTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08067-3319
Mailing Address - Country:US
Mailing Address - Phone:304-482-8441
Mailing Address - Fax:
Practice Address - Street 1:4755 OGLETOWN STANTON RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718-2200
Practice Address - Country:US
Practice Address - Phone:304-482-8441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-24
Last Update Date:2020-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0011470363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
DELG-0011470OtherDE BOARD OF NURSING