Provider Demographics
NPI:1619496486
Name:PODLOGAR, JULIE (CNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:PODLOGAR
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 1:7818 APPLE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:OH
Mailing Address - Zip Code:44276-9741
Mailing Address - Country:US
Mailing Address - Phone:330-715-5317
Mailing Address - Fax:
Practice Address - Street 1:1740 CLEVELAND RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-2204
Practice Address - Country:US
Practice Address - Phone:330-287-5928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH021211363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care