Healthcare Provider Details

I. General information

NPI: 1407574288
Provider Name (Legal Business Name): JULIANNA MARIE CURTIS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2022
Last Update Date: 02/12/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61250 SE COOMBS PL
BEND OR
97702-3704
US

IV. Provider business mailing address

1149 COLUMBINE ST APT 204
DENVER CO
80206-3144
US

V. Phone/Fax

Practice location:
  • Phone: 541-706-5930
  • Fax:
Mailing address:
  • Phone: 505-264-6876
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0997913-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: