Provider Demographics
NPI:1801502323
Name:CAOUETTE, JULIA MICHELLE (APRN, MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:MICHELLE
Last Name:CAOUETTE
Suffix:
Gender:F
Credentials:APRN, MSN, FNP-C
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:MICHELLE
Other - Last Name:GOCLOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 PLAINFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MOOSUP
Mailing Address - State:CT
Mailing Address - Zip Code:06354-1632
Mailing Address - Country:US
Mailing Address - Phone:860-822-4938
Mailing Address - Fax:
Practice Address - Street 1:120 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:MOOSUP
Practice Address - State:CT
Practice Address - Zip Code:06354-1632
Practice Address - Country:US
Practice Address - Phone:860-822-4938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-27
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11454363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT11454OtherLICENSE NUMBER