Provider Demographics
NPI:1255056321
Name:MIKULICH, JULIA (NP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:MIKULICH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 ROUTE 108
Mailing Address - Street 2:
Mailing Address - City:SOMERSWORTH
Mailing Address - State:NH
Mailing Address - Zip Code:03878-1522
Mailing Address - Country:US
Mailing Address - Phone:603-749-2346
Mailing Address - Fax:603-953-0066
Practice Address - Street 1:311 ROUTE 108
Practice Address - Street 2:
Practice Address - City:SOMERSWORTH
Practice Address - State:NH
Practice Address - Zip Code:03878-1522
Practice Address - Country:US
Practice Address - Phone:603-749-2346
Practice Address - Fax:603-953-0066
Is Sole Proprietor?:No
Enumeration Date:2022-10-11
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH066315-23363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner