Healthcare Provider Details
I. General information
NPI: 1548712748
Provider Name (Legal Business Name): JULIA BERLIN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/04/2016
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3407 WILKENS AVE STE 300
BALTIMORE MD
21229-5222
US
IV. Provider business mailing address
3407 WILKENS AVE STE 300
BALTIMORE MD
21229-5222
US
V. Phone/Fax
- Phone: 410-644-5111
- Fax:
- Phone: 410-644-5111
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | R176543 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: