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General NPI Number Information
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NPI Number | 1053369249
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Entity Type | Individual
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Provider Name | JULIA S. LUPA NP
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Gender | Female
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Dates
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Enumeration Date | 05/04/2006
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Last Update Date | 11/18/2015
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Provider Practice Location Address
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Address Line | 771 OLD NORCROSS RD SUITE 305
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046
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Country | US
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Telephone | 770-339-4000
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Fax | 770-339-9037
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Provider Business Mailing Address
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Address Line | 771 OLD NORCROSS RD SUITE 305
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046
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Country | US
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Telephone | 770-339-4000
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Fax | 770-339-9037
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | RN072457
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License Number State | GA
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