Healthcare Provider Details

I. General information

NPI: 1063164689
Provider Name (Legal Business Name): JULIANA GEORGE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2022
Last Update Date: 01/25/2022
Certification Date: 01/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7606 FONTAINEBLEAU DR APT 209
NEW CARROLLTON MD
20784-3808
US

IV. Provider business mailing address

7606 FONTAINEBLEAU DR APT 209
NEW CARROLLTON MD
20784-3808
US

V. Phone/Fax

Practice location:
  • Phone: 301-655-6396
  • Fax: 410-946-2010
Mailing address:
  • Phone: 301-655-6396
  • Fax: 410-946-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: