Provider Demographics
NPI:1003469487
Name:ZEAL, JULIA GUEST (APRN)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:GUEST
Last Name:ZEAL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2504 NW MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-5510
Mailing Address - Country:US
Mailing Address - Phone:317-750-0781
Mailing Address - Fax:
Practice Address - Street 1:244 NE DIVISION ST
Practice Address - Street 2:
Practice Address - City:MYRTLE CREEK
Practice Address - State:OR
Practice Address - Zip Code:97457-8507
Practice Address - Country:US
Practice Address - Phone:844-311-5548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201905046NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily