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General NPI Number Information
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NPI Number | 1811573926
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Entity Type | Individual
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Provider Name | JULIE L SHUBERT CRNP
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Gender | Female
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Dates
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Enumeration Date | 03/19/2021
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Last Update Date | 03/19/2021
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Provider Practice Location Address
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Address Line | 7500 CENTRAL AVE STE 205
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City | PHILADELPHIA
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State | PA
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Zip | 19111-2432
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Country | US
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Telephone | 215-728-7711
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Fax | 215-725-2795
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Provider Business Mailing Address
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Address Line | 306 PEMBROOK AVE
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City | MOORESTOWN
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State | NJ
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Zip | 08057-3413
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Country | US
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Telephone | 856-986-3225
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 26NJ01007300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | SP021766
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License Number State | PA
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