Provider Demographics
NPI:1871594788
Name:WAIGHT, JULIE (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:WAIGHT
Suffix:
Gender:
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01062-1466
Mailing Address - Country:US
Mailing Address - Phone:413-586-8400
Mailing Address - Fax:866-644-0872
Practice Address - Street 1:70 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:MA
Practice Address - Zip Code:01062-1466
Practice Address - Country:US
Practice Address - Phone:413-586-8400
Practice Address - Fax:866-644-0872
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF332392363LF0000X
CT002122363LF0000X
MARN10019601363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
50000 1060OtherMEDICARE CONN
50000 1060OtherMEDICARE CONN
NY94N351Medicare ID - Type Unspecified