Provider Demographics
NPI:1871000323
Name:JARVIS, JULIANNA NICOLE (PA-C)
Entity type:Individual
Prefix:
First Name:JULIANNA
Middle Name:NICOLE
Last Name:JARVIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JULIANNA
Other - Middle Name:NICOLE
Other - Last Name:JARVIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA-C
Mailing Address - Street 1:200 N 16TH ST STE D
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-1202
Mailing Address - Country:US
Mailing Address - Phone:215-315-3197
Mailing Address - Fax:215-689-4466
Practice Address - Street 1:200 N 16TH ST STE D
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-1202
Practice Address - Country:US
Practice Address - Phone:215-315-3197
Practice Address - Fax:215-689-4466
Is Sole Proprietor?:No
Enumeration Date:2018-01-05
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical