Provider Demographics
NPI:1932822434
Name:WEST, JULIA FITZGERALD (RN)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:FITZGERALD
Last Name:WEST
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 PULLMAN AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14217-1516
Mailing Address - Country:US
Mailing Address - Phone:716-341-0058
Mailing Address - Fax:
Practice Address - Street 1:82 RUTLAND ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14220-1628
Practice Address - Country:US
Practice Address - Phone:585-944-2838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY819814163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse