Provider Demographics
NPI:1881948982
Name:PADILLA, JULIE MARGARET (APN)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:MARGARET
Last Name:PADILLA
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2931 MONTANA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903-2409
Mailing Address - Country:US
Mailing Address - Phone:915-562-4246
Mailing Address - Fax:915-564-0667
Practice Address - Street 1:2931 MONTANA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-2409
Practice Address - Country:US
Practice Address - Phone:915-562-4246
Practice Address - Fax:915-564-0667
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-29
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX501309363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner