Provider Demographics
NPI:1689362998
Name:STODDARD, JULIE ELIZABETH (APRN)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ELIZABETH
Last Name:STODDARD
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ELIZABETH
Other - Last Name:KRISTIANSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:901 WAYNE ST
Mailing Address - Street 2:
Mailing Address - City:OLEAN
Mailing Address - State:NY
Mailing Address - Zip Code:14760-2255
Mailing Address - Country:US
Mailing Address - Phone:716-402-7026
Mailing Address - Fax:716-215-6170
Practice Address - Street 1:901 WAYNE ST
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-2255
Practice Address - Country:US
Practice Address - Phone:716-402-7026
Practice Address - Fax:716-215-6170
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY356031363LF0000X
HIAPRN-4028-0363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily