Provider Demographics
NPI:1588648406
Name:BUEDEL, JULIE K (OTR/CHT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:K
Last Name:BUEDEL
Suffix:
Gender:F
Credentials:OTR/CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5629
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47716-5629
Mailing Address - Country:US
Mailing Address - Phone:812-476-0409
Mailing Address - Fax:812-476-1016
Practice Address - Street 1:5625 PEARL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47712-8106
Practice Address - Country:US
Practice Address - Phone:812-759-7493
Practice Address - Fax:812-401-2346
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31001535A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000178772OtherBLUE CROSS BLUE SHIELD
IN200839340Medicaid
IN000000178772OtherBLUE CROSS BLUE SHIELD
IN200839340Medicaid