Healthcare Provider Details

I. General information

NPI: 1083226179
Provider Name (Legal Business Name): JULIANA MILLER HODGES DNP, RN, CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2020
Last Update Date: 06/17/2021
Certification Date: 06/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 FAYETTEVILLE ST
DURHAM NC
27707-2398
US

IV. Provider business mailing address

1301 FAYETTEVILLE ST
DURHAM NC
27707-2398
US

V. Phone/Fax

Practice location:
  • Phone: 919-956-4074
  • Fax:
Mailing address:
  • Phone: 919-956-4074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number1-153263
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number1-153263
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1-153263
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: