Provider Demographics
NPI:1457879314
Name:BAILEY, JULIE A (NP-C)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:BAILEY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:JUDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3450 11TH CT # 104
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-5012
Mailing Address - Country:US
Mailing Address - Phone:772-226-4830
Mailing Address - Fax:772-226-4835
Practice Address - Street 1:3450 11TH CT # 104
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5012
Practice Address - Country:US
Practice Address - Phone:772-226-4830
Practice Address - Fax:772-226-4835
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9268876363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDINGMedicaid
FLPENDINGOtherMEDICARE