Provider Demographics
NPI:1619508082
Name:CARLISLE, JULIE (STNA)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:CARLISLE
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:CARLISLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1047 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-2215
Mailing Address - Country:US
Mailing Address - Phone:234-320-8226
Mailing Address - Fax:
Practice Address - Street 1:1047 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-2215
Practice Address - Country:US
Practice Address - Phone:234-320-8226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide