Provider Demographics
NPI:1750582748
Name:ROEDELL, JULIE TIMMERMAN (MSN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:TIMMERMAN
Last Name:ROEDELL
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Gender:F
Credentials:MSN, FNP-C
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Mailing Address - Street 1:1804 EMBARCADERO RD
Mailing Address - Street 2:STE 100
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94303-3341
Mailing Address - Country:US
Mailing Address - Phone:408-615-7793
Mailing Address - Fax:408-615-7023
Practice Address - Street 1:300 PASTEUR DR
Practice Address - Street 2:H2149, MC 5233
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-725-7566
Practice Address - Fax:650-725-7568
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2016-10-14
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Provider Licenses
StateLicense IDTaxonomies
CA13589363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS52840Medicare UPIN