Provider Demographics
NPI:1508306499
Name:MCCALL, JULIE H (CRNA)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:H
Last Name:MCCALL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:HEHNEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNRA
Mailing Address - Street 1:4665 DOUGLAS CIR NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-3673
Mailing Address - Country:US
Mailing Address - Phone:330-499-5700
Mailing Address - Fax:330-498-4229
Practice Address - Street 1:1320 MERCY DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-2614
Practice Address - Country:US
Practice Address - Phone:330-489-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-27
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CRNA.019453367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0212265Medicaid