Provider Demographics
NPI:1881114536
Name:EASTERDAY, JULIE CRISTINA (FNP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:CRISTINA
Last Name:EASTERDAY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:CRISTINA
Other - Last Name:MUNDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:17176 S MESA SHADOWS DR
Mailing Address - Street 2:
Mailing Address - City:VAIL
Mailing Address - State:AZ
Mailing Address - Zip Code:85641-2470
Mailing Address - Country:US
Mailing Address - Phone:520-400-8246
Mailing Address - Fax:
Practice Address - Street 1:13180 E COLOSSAL CAVE RD STE 150
Practice Address - Street 2:
Practice Address - City:VAIL
Practice Address - State:AZ
Practice Address - Zip Code:85641-8757
Practice Address - Country:US
Practice Address - Phone:520-762-1557
Practice Address - Fax:520-762-8019
Is Sole Proprietor?:No
Enumeration Date:2017-06-23
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP10153363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily