Healthcare Provider Details

I. General information

NPI: 1649041856
Provider Name (Legal Business Name): JULIA P MARTELL NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2024
Last Update Date: 01/16/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 ROBERT SMALLS PKWY
BEAUFORT SC
29906-4200
US

IV. Provider business mailing address

21 ROBERT SMALLS PKWY
BEAUFORT SC
29906-4200
US

V. Phone/Fax

Practice location:
  • Phone: 843-510-6550
  • Fax:
Mailing address:
  • Phone: 610-657-3911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number28283
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: