Provider Demographics
NPI:1053182113
Name:ADAMS, JULIA
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8635 LOCUST GROVE DR
Mailing Address - Street 2:
Mailing Address - City:PORT TOBACCO
Mailing Address - State:MD
Mailing Address - Zip Code:20677-2064
Mailing Address - Country:US
Mailing Address - Phone:443-942-1966
Mailing Address - Fax:
Practice Address - Street 1:1014 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-4228
Practice Address - Country:US
Practice Address - Phone:240-342-3240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR250874163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse