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Individual

JULIE WILLIARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN FNP C

Contact information

Practice address
690 DALLAS HWY, SUITE 101, VILLA RICA, GA 30180-1264
(770) 459-0620
(770) 456-7604
Mailing address
690 DALLAS HWY, SUITE 101, VILLA RICA, GA 30180-1264
(770) 459-0620
(770) 456-7604

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN086758NP
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00812578
GA
Enumeration date
02/17/2006
Last updated
09/21/2012
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