Healthcare Provider Details

I. General information

NPI: 1588127724
Provider Name (Legal Business Name): JULIE ANN JAARSMA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. JULIE ANN JAARSMA-HOLDOM

II. Dates (important events)

Enumeration Date: 04/12/2019
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BOYDEN AVE APT 363
MAPLEWOOD NJ
07040-2685
US

IV. Provider business mailing address

200 BOYDEN AVE APT 363
MAPLEWOOD NJ
07040-2685
US

V. Phone/Fax

Practice location:
  • Phone: 201-338-0751
  • Fax: 973-658-6750
Mailing address:
  • Phone: 201-338-0751
  • Fax: 973-658-6750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF34227-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF344227-1
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ00911700
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00911700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: