Healthcare Provider Details

I. General information

NPI: 1053044107
Provider Name (Legal Business Name): JULIANNE MACMULLEN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2022
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5127 W NOBLE AVE
VISALIA CA
93277-8354
US

IV. Provider business mailing address

1510 E HERNDON AVE STE 310
FRESNO CA
93720-3393
US

V. Phone/Fax

Practice location:
  • Phone: 559-713-6515
  • Fax: 559-713-6516
Mailing address:
  • Phone: 559-326-1222
  • Fax: 559-421-7004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95021543
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95021543
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: