Basic Information
| Provider Information | |||||||||
| NPI: | 1871192443 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VERMEULEN | ||||||||
| FirstName: | JULIA | ||||||||
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| Credential: | RN, CNM, WHNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 156 WOOD ST | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029092146 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7819858375 | ||||||||
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| Practice Location | |||||||||
| Address1: | 18 IMPERIAL PL UNIT 2D | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029034642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4017274800 | ||||||||
| FaxNumber: | 4019216923 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/23/2020 | ||||||||
| LastUpdateDate: | 12/03/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/03/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | 367A00000X | CNM00189 | RI | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.