Provider Demographics
NPI:1053648642
Name:AUTON, JULIA K (APN)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:K
Last Name:AUTON
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N STATE HIGHWAY 121
Mailing Address - Street 2:
Mailing Address - City:MT ZION
Mailing Address - State:IL
Mailing Address - Zip Code:62549-1224
Mailing Address - Country:US
Mailing Address - Phone:217-864-5531
Mailing Address - Fax:217-864-2449
Practice Address - Street 1:1200 N STATE HIGHWAY 121
Practice Address - Street 2:
Practice Address - City:MT ZION
Practice Address - State:IL
Practice Address - Zip Code:62549-1224
Practice Address - Country:US
Practice Address - Phone:217-864-5531
Practice Address - Fax:217-864-2449
Is Sole Proprietor?:No
Enumeration Date:2009-11-03
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209007828363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily