Healthcare Provider Details

I. General information

NPI: 1205825296
Provider Name (Legal Business Name): JULIANNE MURTHI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIANNE GLANCY

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 10/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

239 PLEASANT ST
CONCORD NH
03301-7504
US

IV. Provider business mailing address

PO BOX 42738
TOWSON MD
21284-2738
US

V. Phone/Fax

Practice location:
  • Phone: 603-224-6561
  • Fax:
Mailing address:
  • Phone: 410-543-1957
  • Fax: 410-543-2951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number063653-23
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number063653-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: