Provider Demographics
NPI:1841208642
Name:HARDING, JULAINE B (APRN)
Entity type:Individual
Prefix:MRS
First Name:JULAINE
Middle Name:B
Last Name:HARDING
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 S ORANGE BLOSSOM TRL
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-6557
Mailing Address - Country:US
Mailing Address - Phone:407-703-9990
Mailing Address - Fax:407-703-9991
Practice Address - Street 1:701 S ORANGE BLOSSOM TRL
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-6557
Practice Address - Country:US
Practice Address - Phone:407-703-9990
Practice Address - Fax:407-703-9991
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11002356363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD648871400Medicaid
MD0627437-00Medicaid
MD648871400Medicaid
DC011799D28Medicare ID - Type UnspecifiedDC METRO MEDICARE NUMBER
MD543M848FMedicare ID - Type UnspecifiedMARYLAND MEDICARE NUMBER
MDP59303Medicare UPIN