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General NPI Number Information
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NPI Number | 1750264628
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Entity Type | Individual
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Provider Name | JULIANNA BRODHECKER CNM
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Gender | Female
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Dates
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Enumeration Date | 07/29/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 475 NJ-70 #101
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City | LAKEWOOD
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State | NJ
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Zip | 08701
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Country | US
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Telephone | 732-364-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 209 HILLCREST AVE
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City | NEPTUNE
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State | NJ
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Zip | 07753-5756
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Country | US
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Telephone | 201-317-4555
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Fax |
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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 | PENDING
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 25ME00092200
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License Number State | NJ
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