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General NPI Number Information
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NPI Number | 1790349645
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Entity Type | Individual
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Provider Name | JULIA SCRIVENER
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Gender | Female
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Dates
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Enumeration Date | 04/25/2019
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Last Update Date | 12/02/2020
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Provider Practice Location Address
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Address Line | 15880 SAN CARLOS BLVD
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City | FORT MYERS
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State | FL
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Zip | 33908-3383
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Country | US
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Telephone | 239-265-9003
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Fax |
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Provider Business Mailing Address
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Address Line | 3500 WAKE FOREST RD
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City | RALEIGH
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State | NC
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Zip | 27609-7307
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28458
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS56408
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License Number State | FL
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