Individual
MRS. JULIA BRANCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1002 PERUQUE CROSSING CT, SUITE 101, O FALLON, MO 63366-2362
(636) 294-5900
(636) 294-5908
Mailing address
1002 PERUQUE CROSSING CT, SUITE 101, O FALLON, MO 63366-2362
(636) 294-5900
(636) 294-5908
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2013015686
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245669316
NPI
—
05
—
1245669316
—
MO
01
—
MA1721
MEDICARE GROUP PTAN
MO
Enumeration date
11/08/2013
Last updated
11/13/2014
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