Provider Demographics
NPI:1275651119
Name:CIACCIA, JULIE A (NP)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:A
Last Name:CIACCIA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9757 WESTPOINT DR
Mailing Address - Street 2:STE 100
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3341
Mailing Address - Country:US
Mailing Address - Phone:317-577-2779
Mailing Address - Fax:317-577-2546
Practice Address - Street 1:9757 WESTPOINT DR
Practice Address - Street 2:STE 100
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-3341
Practice Address - Country:US
Practice Address - Phone:317-577-2779
Practice Address - Fax:317-577-2546
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71000984174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist