Provider Demographics
NPI:1336157114
Name:BARBOZA, JULIE A (NP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:BARBOZA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:BARBOZA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:1400 VFW PKWY
Mailing Address - Street 2:
Mailing Address - City:WEST ROXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02132-4927
Mailing Address - Country:US
Mailing Address - Phone:857-203-6842
Mailing Address - Fax:857-203-6412
Practice Address - Street 1:1400 VFW PKWY
Practice Address - Street 2:
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-4927
Practice Address - Country:US
Practice Address - Phone:857-203-6842
Practice Address - Fax:857-203-6412
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251938163W00000X, 363L00000X
MARN251938363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP4324OtherBLUE CROSS
MAAA30775OtherHARVARD PILGRIM
MA0399914Medicaid
MAP00256313OtherMEDICARE RAILROAD
MAAA30775OtherHARVARD PILGRIM
MAQ01096Medicare UPIN