Provider Demographics
NPI:1437740032
Name:SELLARS, JULI ANN (RN)
Entity Type:Individual
Prefix:
First Name:JULI
Middle Name:ANN
Last Name:SELLARS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1484 PAYASO CT
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026-3745
Mailing Address - Country:US
Mailing Address - Phone:636-489-9519
Mailing Address - Fax:
Practice Address - Street 1:15025 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011-4626
Practice Address - Country:US
Practice Address - Phone:636-227-9436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO142456163WG0000X, 163WR0400X
MO142455163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation