Individual
JULIANA GULLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2514 E DUPONT RD STE 100, FORT WAYNE, IN 46825-1619
(260) 484-8830
(260) 483-1911
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(855) 963-2100
(813) 321-1296
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
28230580A
IN
363L00000X
Nurse Practitioner
Primary
71014502A
IN
Other
Enumeration date
08/14/2023
Last updated
01/28/2026
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