Healthcare Provider Details

I. General information

NPI: 1376648931
Provider Name (Legal Business Name): JULIE LYNN STUART APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE LYNN SERENI APRN, FNP-BC

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 12/26/2019
Certification Date: 12/26/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1208 HOSPITAL DR
HURRICANE WV
25526-8708
US

IV. Provider business mailing address

1208 HOSPITAL DR
HURRICANE WV
25526-8708
US

V. Phone/Fax

Practice location:
  • Phone: 304-757-5747
  • Fax: 304-757-5744
Mailing address:
  • Phone: 304-757-5747
  • Fax: 304-757-5744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number52366
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: