Healthcare Provider Details

I. General information

NPI: 1528400801
Provider Name (Legal Business Name): JULIE ANN MEFFERD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE ANN JOHNSON RN

II. Dates (important events)

Enumeration Date: 07/26/2013
Last Update Date: 07/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 BAY PINES BLVD
BAY PINES FL
33744-8200
US

IV. Provider business mailing address

10000 BAY PINES BLVD
BAY PINES FL
33744-8200
US

V. Phone/Fax

Practice location:
  • Phone: 727-398-6661
  • Fax:
Mailing address:
  • Phone: 727-398-6661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR039435
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number062442
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License NumberRN 9357724
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: