Provider Demographics
NPI:1790267243
Name:STANKIEWICZ, JULIE (LVN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:STANKIEWICZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6823 COLUMBIA RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-3418
Mailing Address - Country:US
Mailing Address - Phone:803-447-4477
Mailing Address - Fax:
Practice Address - Street 1:6823 COLUMBIA RIDGE DR
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-3418
Practice Address - Country:US
Practice Address - Phone:803-447-4477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX340719164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse