Provider Demographics
NPI:1275862724
Name:MAYLE, JULIE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:MAYLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:ONEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7867 BLACKLICK VIEW DR
Mailing Address - Street 2:
Mailing Address - City:BLACKLICK
Mailing Address - State:OH
Mailing Address - Zip Code:43004-5018
Mailing Address - Country:US
Mailing Address - Phone:740-707-8901
Mailing Address - Fax:
Practice Address - Street 1:275 WATSON WAY
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-7213
Practice Address - Country:US
Practice Address - Phone:740-444-4499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-11
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN349357163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse