Provider Demographics
NPI:1184227480
Name:HITES, JULIE LEE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LEE
Last Name:HITES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4487 NUTWOOD AVE NW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-1614
Mailing Address - Country:US
Mailing Address - Phone:330-883-8433
Mailing Address - Fax:
Practice Address - Street 1:4487 NUTWOOD AVE NW
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-1614
Practice Address - Country:US
Practice Address - Phone:330-883-8433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant