1396829198 NPI number — CYNTHIA JULICH FNP-C

Table of content: CYNTHIA JULICH FNP-C (NPI 1396829198)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396829198 NPI number — CYNTHIA JULICH FNP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JULICH
Provider First Name:
CYNTHIA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396829198
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/14/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2412 WILKINS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SANFORD
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27330-7268
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-776-6000
Provider Business Mailing Address Fax Number:
919-776-1751

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2412 WILKINS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANFORD
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27330-7268
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-776-6000
Provider Business Practice Location Address Fax Number:
919-776-1751
Provider Enumeration Date:
10/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  200481 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 080065373 . This is a "RR MEDICARE-PITTSBORO" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 52925 . This is a "MEDCOST-SANFORD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 0151824 . This is a "UNITEDHEALTHCARE-PITTSBOR" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 25528 . This is a "MEDCOST-PITTSBORO" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 0151826 . This is a "UNITEDHEALTHCARE-SANFORD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 43454 . This is a "BCBS" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 080152361 . This is a "RR MEDCARE-SANFORD" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 152734500 . This is a "US DEPT OF LABOR" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 7003952 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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