Provider Demographics
NPI:1477105047
Name:WHEELER, JULIE ELLEN (ARNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ELLEN
Last Name:WHEELER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1505 W HAYES ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52804-1746
Mailing Address - Country:US
Mailing Address - Phone:563-370-7301
Mailing Address - Fax:
Practice Address - Street 1:2535 MAPLECREST RD STE 16
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-2799
Practice Address - Country:US
Practice Address - Phone:563-421-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA155619363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily