Basic Information
| Provider Information | |||||||||
| NPI: | 1598989493 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CUZNER | ||||||||
| FirstName: | JULIA | ||||||||
| MiddleName: | R. | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | NURSE PRACTITIONER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 81 HIGHLAND AVE | ||||||||
| Address2: | NORTH SHORE MEDICAL CENTER PREOPERATIVE TESTING CENTER | ||||||||
| City: | SALEM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019705309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9787411200 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 81 HIGHLAND AVE | ||||||||
| Address2: | NORTH SHORE MEDICAL CENTER PREOPERATIVE TESTING CENTER | ||||||||
| City: | SALEM | ||||||||
| State: | MA | ||||||||
| PostalCode: | 019702714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9787411200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 223339 | MA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
ID Information
| ID | Type | State | Issuer | Description | 0326330 | 05 | MA | MEDICAID | 8302371 | 01 | MA | EVER CARE | OTHER | NP 4350 | 01 | MA | BLUE CARE | OTHER | NP4350 | 01 | MA | BLUE CARE ELECT | OTHER | NP4350 | 01 | MA | BLUE CROSS BLUE SHIELD | OTHER | 003176 | 01 | MA | SENIOR WHOLE HEALTH | OTHER | 21246428192 | 01 | MA | BEECH ST | OTHER | NP4350 | 01 | MA | HMO BLUE | OTHER | 91325 | 01 | MA | 91325 | OTHER |