Provider Demographics
NPI:1659560548
Name:CASE, JULIA GAYLE (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:GAYLE
Last Name:CASE
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2004 NORTH HWY 81
Mailing Address - Street 2:
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533
Mailing Address - Country:US
Mailing Address - Phone:580-252-1911
Mailing Address - Fax:580-252-1020
Practice Address - Street 1:2004 NORTH HWY 81
Practice Address - Street 2:
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533
Practice Address - Country:US
Practice Address - Phone:580-252-1911
Practice Address - Fax:580-252-1020
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKF1007048363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200133900CMedicaid
OK247801501Medicare PIN