Provider Demographics
NPI:1780990291
Name:HATHAWAY, JULIE (RN, BSN)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:HATHAWAY
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:RELOZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:6460 E NORTHERN LIGHTS BLVD APT 11B
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-3382
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6460 E NORTHERN LIGHTS BLVD APT 11B
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-3382
Practice Address - Country:US
Practice Address - Phone:907-333-6068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK23339163W00000X
FL9217710163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse