Provider Demographics
NPI:1114352440
Name:FLANTOILL, JULIE ANN (LPN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:FLANTOILL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12158 BIRCHHILL DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251-4203
Mailing Address - Country:US
Mailing Address - Phone:513-693-5312
Mailing Address - Fax:
Practice Address - Street 1:12158 BIRCHHILL DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45251-4203
Practice Address - Country:US
Practice Address - Phone:513-693-5312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.141839-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse