MEDICARE: JULIE MARIE HUSTON APRN

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
1	207Q00000X	Family Medicine Physician	14667	CT

General Provider Information

NPI Number	:	1366246910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE MARIE HUSTON APRN

Provider Business Mailing Address
First Line	:	415 KILLINGWORTH RD
Second Line	:
City	:	HIGGANUM
State	:	CT
Zip	:	06441-4392
Country	:	US
Telephone Number	:	860-345-8535
Fax Number	:

Provider Business Practice Location Address
First Line	:	415 KILLINGWORTH RD
Second Line	:
City	:	HIGGANUM
State	:	CT
Zip	:	06441-4392
Country	:	US
Telephone Number	:	860-345-8535
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2025
Last Update Date	:	04/02/2025

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