Provider Demographics
NPI:1467742536
Name:YACHINICH, JULIE MARLENE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:MARLENE
Last Name:YACHINICH
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 1:7834 W BEECHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-4959
Mailing Address - Country:US
Mailing Address - Phone:414-760-9245
Mailing Address - Fax:
Practice Address - Street 1:7834 W BEECHWOOD AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-4959
Practice Address - Country:US
Practice Address - Phone:414-760-9245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-11
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15785-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse