Provider Demographics
NPI:1376964452
Name:TACARDON, JULIANA (DNP FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JULIANA
Middle Name:
Last Name:TACARDON
Suffix:
Gender:F
Credentials:DNP FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:348 DAVIS AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-1548
Mailing Address - Country:US
Mailing Address - Phone:718-603-9101
Mailing Address - Fax:
Practice Address - Street 1:307 EGG HARBOR RD
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-1850
Practice Address - Country:US
Practice Address - Phone:856-589-1177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-17
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY640481163W00000X
NJ26NJ01400700363LF0000X
CA95023762363LF0000X
CT10827363LF0000X
FL11018009363LF0000X
KS53-82441-062363LF0000X
DELG-0012364363LF0000X
OHAPRN.CNP.0035859363LF0000X
KY4017060363LF0000X
MDAC005518363LF0000X
MECNP231070363LF0000X
NH091030-23363LF0000X
RIAPRN03744363LF0000X
NY344068363LF0000X
PASP024800363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse