Provider Demographics
NPI:1518107457
Name:HEDGES, JULIE ALYSSE (RN, CPNP-AC)
Entity Type:Individual
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First Name:JULIE
Middle Name:ALYSSE
Last Name:HEDGES
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Gender:F
Credentials:RN, CPNP-AC
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Mailing Address - Street 1:8601 FLORENCE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63144-2404
Mailing Address - Country:US
Mailing Address - Phone:309-287-4069
Mailing Address - Fax:
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:309-287-4069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-05
Last Update Date:2023-05-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2008036648363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care