Provider Demographics
NPI:1659073716
Name:WHITCOMB, JULIA ANN MARIE (CHES)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ANN MARIE
Last Name:WHITCOMB
Suffix:
Gender:F
Credentials:CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 EMILY LN
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-6483
Mailing Address - Country:US
Mailing Address - Phone:507-995-7844
Mailing Address - Fax:
Practice Address - Street 1:108 EMILY LN
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-6483
Practice Address - Country:US
Practice Address - Phone:507-995-7844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN28432174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator