Provider Demographics
NPI:1568550093
Name:WALTER, JULIE RACHELLE (OD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:RACHELLE
Last Name:WALTER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:RACHELLE
Other - Last Name:GERMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1020 LEAVENWORTH ST APT 229
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-2904
Mailing Address - Country:US
Mailing Address - Phone:402-502-0263
Mailing Address - Fax:
Practice Address - Street 1:717 N 98TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2340
Practice Address - Country:US
Practice Address - Phone:402-399-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2018-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1250152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist