MEDICARE: JULIET JOHN FNP

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	364SF0001X	Family Health Clinical Nurse Specialist	SP026161	PA
2	363LF0000X	Family Nurse Practitioner	SP026161	PA

General Provider Information

NPI Number	:	1952010076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIET JOHN FNP

Provider Business Mailing Address
First Line	:	1308 COTTMAN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-3606
Country	:	US
Telephone Number	:	267-267-4567
Fax Number	:	267-267-4568

Provider Business Practice Location Address
First Line	:	1308 COTTMAN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-3606
Country	:	US
Telephone Number	:	267-267-4567
Fax Number	:	267-267-4568

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

Provider Enumeration Date	:	11/17/2022
Last Update Date	:	11/25/2025

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