Provider Demographics
NPI:1649878380
Name:JULIAN, BARBARA (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:JULIAN
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 STATE ROUTE 35 APT 109
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07762-2533
Mailing Address - Country:US
Mailing Address - Phone:732-682-8345
Mailing Address - Fax:
Practice Address - Street 1:751 RTE 37 W
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-5032
Practice Address - Country:US
Practice Address - Phone:732-503-9966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR06122900163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ000000000Medicaid