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NPI Code Detail

MEDICARE: MRS. JULIE RENEE KERTH CPNP-AC

MEDICARE: MRS. JULIE RENEE KERTH CPNP-AC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12080P0214XPediatric Pulmonology Physician5010246NC
2363LP0200XPediatric Nurse Practitioner5010246NC

General Provider Information

NPI Number : 1023519543
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JULIE RENEE KERTH CPNP-AC
Provider Business Mailing Address
First Line : 1 MEDICAL CENTER BLVD
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27157-0001
Country : US
Telephone Number : 336-713-4500
Fax Number :
Provider Business Practice Location Address
First Line : WAKE FOREST BAPTIST MEDICAL CENTER 1
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27157-0001
Country : US
Telephone Number : 336-713-4500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2018
Last Update Date : 03/17/2018

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