Provider Demographics
NPI:1881472884
Name:HETRICK, JULIA (PAC)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:HETRICK
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:15065 KUTZTOWN RD
Mailing Address - Street 2:
Mailing Address - City:KUTZTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19530-9220
Mailing Address - Country:US
Mailing Address - Phone:484-822-8001
Mailing Address - Fax:484-822-8002
Practice Address - Street 1:15065 KUTZTOWN RD
Practice Address - Street 2:
Practice Address - City:KUTZTOWN
Practice Address - State:PA
Practice Address - Zip Code:19530-9220
Practice Address - Country:US
Practice Address - Phone:484-822-8001
Practice Address - Fax:484-822-8002
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA064893363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant