Provider Demographics
NPI:1336630888
Name:JOHN SAMUEL, JULIA MARY (DNP, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:MARY
Last Name:JOHN SAMUEL
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4120 W MEMORIAL RD STE 102
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-9322
Mailing Address - Country:US
Mailing Address - Phone:405-749-4205
Mailing Address - Fax:405-749-4248
Practice Address - Street 1:4120 W MEMORIAL RD STE 102
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-9322
Practice Address - Country:US
Practice Address - Phone:405-749-4205
Practice Address - Fax:405-749-4248
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0109634363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily