Provider Demographics
NPI:1730142555
Name:CODDINGTON, JULIA J (NPC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:J
Last Name:CODDINGTON
Suffix:
Gender:F
Credentials:NPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 GREEN VALLEY RD
Mailing Address - Street 2:STE1
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-4648
Mailing Address - Country:US
Mailing Address - Phone:812-945-4000
Mailing Address - Fax:812-941-5714
Practice Address - Street 1:2210 GREEN VALLEY RD
Practice Address - Street 2:STE1
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4648
Practice Address - Country:US
Practice Address - Phone:812-945-4000
Practice Address - Fax:812-941-5714
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001876A363L00000X
KY4749P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200501030BMedicaid
IN200501030DMedicaid
IN200501030AMedicaid
INQ31367Medicare UPIN
IN196240IMedicare PIN
IN200501030BMedicaid
IN243690LMedicare PIN