Individual
JULIA MARIA LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
110 S 17TH ST, HARRISBURG, PA 17104-1123
(717) 232-9971
(717) 920-3039
Mailing address
110 S 17TH ST, HARRISBURG, PA 17104-1123
(717) 232-9971
(717) 920-3039
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
SP019117
PA
363LP2300X
Primary Care Nurse Practitioner
Primary
SP019117
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102250300-0004
—
PA
Enumeration date
08/28/2018
Last updated
12/08/2022
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