Basic Information
Provider Information
NPI: 1922156298
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NESBIT
FirstName: JULIE
MiddleName: CRUTCHFIELD
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2511 OLD CORNWALLIS RD STE 200
Address2:  
City: DURHAM
State: NC
PostalCode: 277131869
CountryCode: US
TelephoneNumber: 9199325700
FaxNumber: 9199336881
Practice Location
Address1: 2511 OLD CORNWALLIS RD STE 200
Address2:  
City: DURHAM
State: NC
PostalCode: 277131869
CountryCode: US
TelephoneNumber: 9199325700
FaxNumber: 9199336881
Other Information
ProviderEnumerationDate: 01/05/2007
LastUpdateDate: 08/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X5000690NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LF0000X0024173602VAN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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