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NPI Code Detail

MEDICARE: JULIANA GULLETT

MEDICARE: JULIANA GULLETT
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
1163WC0200XCritical Care Medicine Registered Nurse28230580AIN
2363L00000XNurse Practitioner71014502AIN

General Provider Information

NPI Number : 1174206338
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIANA GULLETT
Provider Business Mailing Address
First Line : PO BOX 749495
Second Line :
City : ATLANTA
State : GA
Zip : 30374-9495
Country : US
Telephone Number : 855-963-2100
Fax Number : 813-321-1296
Provider Business Practice Location Address
First Line : 2514 E DUPONT RD STE 100
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-1619
Country : US
Telephone Number : 260-484-8830
Fax Number : 260-483-1911
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2023
Last Update Date : 01/28/2026

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Directions to “ JULIANA GULLETT ” Practice Location

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