Healthcare Provider Details

I. General information

NPI: 1396437554
Provider Name (Legal Business Name): JULIA OHARA CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2023
Last Update Date: 05/24/2023
Certification Date: 05/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 ROUTE 70 E
CHERRY HILL NJ
08034-2409
US

IV. Provider business mailing address

301 S 8TH ST STE 2L
PHILADELPHIA PA
19106-4017
US

V. Phone/Fax

Practice location:
  • Phone: 800-516-5315
  • Fax: 517-787-7365
Mailing address:
  • Phone: 800-516-5315
  • Fax: 517-787-7365

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number26NR21279200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: