Healthcare Provider Details

I. General information

NPI: 1821978909
Provider Name (Legal Business Name): JULIE LYNNE ULIANO PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE LYNNE MALACUSKY PA

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 WESLEY ST STE 3
JOHNSON CITY TN
37601-1741
US

IV. Provider business mailing address

302 WESLEY ST STE 3
JOHNSON CITY TN
37601-1741
US

V. Phone/Fax

Practice location:
  • Phone: 423-282-0561
  • Fax:
Mailing address:
  • Phone: 423-282-0561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number6251
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number6251
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: