Provider Demographics
NPI:1700188588
Name:NEVELLS, JULIANN MARIE (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JULIANN
Middle Name:MARIE
Last Name:NEVELLS
Suffix:
Gender:F
Credentials:MS, OTR/L
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 670117
Mailing Address - Street 2:
Mailing Address - City:CHUGIAK
Mailing Address - State:AK
Mailing Address - Zip Code:99567-0117
Mailing Address - Country:US
Mailing Address - Phone:907-441-8817
Mailing Address - Fax:899-370-0295
Practice Address - Street 1:19436 KULLBERG DR
Practice Address - Street 2:
Practice Address - City:CHUGIAK
Practice Address - State:AK
Practice Address - Zip Code:99567-6381
Practice Address - Country:US
Practice Address - Phone:907-688-1277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1684225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist