Provider Demographics
NPI:1568112191
Name:ROUSH, JULIE ANN (CNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:ROUSH
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 1:4894 BRIGGS RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45133-9458
Mailing Address - Country:US
Mailing Address - Phone:937-403-6714
Mailing Address - Fax:
Practice Address - Street 1:4894 BRIGGS RD
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OH
Practice Address - Zip Code:45133-9458
Practice Address - Country:US
Practice Address - Phone:937-393-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031057363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily