Provider Demographics
NPI:1518295435
Name:MENETREY, JULIA ANN (CNP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ANN
Last Name:MENETREY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4760 E GALBRAITH RD
Mailing Address - Street 2:STE. 205
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-6703
Mailing Address - Country:US
Mailing Address - Phone:513-985-0741
Mailing Address - Fax:513-985-0784
Practice Address - Street 1:4760 E GALBRAITH RD
Practice Address - Street 2:STE. 205
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-6703
Practice Address - Country:US
Practice Address - Phone:513-985-0741
Practice Address - Fax:513-985-0784
Is Sole Proprietor?:No
Enumeration Date:2009-12-04
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006243363L00000X
OH11228363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00922872OtherRR MEDICARE
OH611300608061OtherCARESOURCE
IN201194490Medicaid
OH3138572Medicaid
KY710011070Medicaid
KYP00922872OtherRR MEDICARE
OH3138572Medicaid