Basic Information
| Provider Information | |||||||||
| NPI: | 1023001088 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DALTON | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16 PAULORNETTE CIR | ||||||||
| Address2: | |||||||||
| City: | ANDOVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018102838 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9784750954 | ||||||||
| FaxNumber: | 2033546182 | ||||||||
| Practice Location | |||||||||
| Address1: | 16 PAULORNETTE CIR | ||||||||
| Address2: | |||||||||
| City: | ANDOVER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 018102838 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9784750954 | ||||||||
| FaxNumber: | 7815957111 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 199781 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.