Healthcare Provider Details

I. General information

NPI: 1114280476
Provider Name (Legal Business Name): JULIA BERNDT RAPP PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 STATE ST
MERIDEN CT
06450-3293
US

IV. Provider business mailing address

19 GRAND ST
MIDDLETOWN CT
06457-2705
US

V. Phone/Fax

Practice location:
  • Phone: 203-237-2229
  • Fax: 203-686-1677
Mailing address:
  • Phone: 860-347-6971
  • Fax: 860-343-7371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60281163
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number16216
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP60281163
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN60281161
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: