Provider Demographics
NPI:1770584096
Name:WALSH, JULIANNE NEMES (PNP)
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:NEMES
Last Name:WALSH
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:JULIANNE
Other - Middle Name:
Other - Last Name:NEMES-WALSH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:230 WORCESTER ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-5420
Mailing Address - Country:US
Mailing Address - Phone:781-431-5523
Mailing Address - Fax:781-431-5518
Practice Address - Street 1:230 WORCESTER ST
Practice Address - Street 2:
Practice Address - City:WELLESLEY
Practice Address - State:MA
Practice Address - Zip Code:02481-5420
Practice Address - Country:US
Practice Address - Phone:781-431-5523
Practice Address - Fax:781-431-5518
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA155359363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner