Provider Demographics
NPI:1669760088
Name:WILLARDSON, JULIE BRYCE (DNP, FNP)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:BRYCE
Last Name:WILLARDSON
Suffix:
Gender:F
Credentials:DNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83960 SPRING HILL LN
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:OR
Mailing Address - Zip Code:97455-9728
Mailing Address - Country:US
Mailing Address - Phone:541-819-0575
Mailing Address - Fax:
Practice Address - Street 1:83960 SPRING HILL LN
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:OR
Practice Address - Zip Code:97455-9728
Practice Address - Country:US
Practice Address - Phone:541-819-0575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-19
Last Update Date:2019-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT302521-4405363LF0000X
OR201404741363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily