Provider Demographics
NPI:1740572627
Name:GLADNEY, JULIE ALAYNE (LPN, IBCLC, RLC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ALAYNE
Last Name:GLADNEY
Suffix:
Gender:F
Credentials:LPN, IBCLC, RLC
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 393
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:OH
Mailing Address - Zip Code:45701-0393
Mailing Address - Country:US
Mailing Address - Phone:740-818-8871
Mailing Address - Fax:740-447-9605
Practice Address - Street 1:217 COLUMBUS RD STE 105
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-1393
Practice Address - Country:US
Practice Address - Phone:740-818-8871
Practice Address - Fax:844-442-5114
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 142244164W00000X
OH108-85240174N00000X
OHL-20141405300000X, 174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No164W00000XNursing Service ProvidersLicensed Practical Nurse
No405300000XOther Service ProvidersPrevention Professional