Provider Demographics
NPI:1801135116
Name:STORELLI, JULIE LORELLE (FNP, PAC)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:LORELLE
Last Name:STORELLI
Suffix:
Gender:F
Credentials:FNP, PAC
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:LORELLE
Other - Last Name:SHUTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, FNP-C, PA-C
Mailing Address - Street 1:6137 N THESTA ST STE 101A
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-8605
Mailing Address - Country:US
Mailing Address - Phone:559-447-9056
Mailing Address - Fax:559-447-5768
Practice Address - Street 1:6137 N THESTA ST STE 101A
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-8605
Practice Address - Country:US
Practice Address - Phone:559-447-9056
Practice Address - Fax:559-447-5768
Is Sole Proprietor?:No
Enumeration Date:2013-02-06
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA604522163WG0000X
CA1073131363A00000X
CA16982363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant