Basic Information
Provider Information
NPI: 1962917856
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MARTIN-VELEZ
FirstName: JULIA
MiddleName: MARCELLA
NamePrefix: DR.
NameSuffix:  
Credential: DNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2000 PERIMETER PARK DR STE 200
Address2:  
City: MORRISVILLE
State: NC
PostalCode: 275608442
CountryCode: US
TelephoneNumber: 9842154110
FaxNumber:  
Practice Location
Address1: 3900 BROWNING PL STE 101
Address2:  
City: RALEIGH
State: NC
PostalCode: 276096529
CountryCode: US
TelephoneNumber: 9197819650
FaxNumber: 9197813572
Other Information
ProviderEnumerationDate: 12/13/2017
LastUpdateDate: 05/04/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/04/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XQ76GSZNCY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home