Provider Demographics
NPI:1730663188
Name:MCLEOD, JULIE RACHEL (PA)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:RACHEL
Last Name:MCLEOD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:112 TOLLGATE CT
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-2944
Mailing Address - Country:US
Mailing Address - Phone:843-870-5139
Mailing Address - Fax:
Practice Address - Street 1:411 ANSEL ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3407
Practice Address - Country:US
Practice Address - Phone:864-232-5368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-21
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical