Provider Demographics
NPI:1821733833
Name:EDEN, JULIA MARIE (CNP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:MARIE
Last Name:EDEN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 E AIRPORT DR
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-3402
Mailing Address - Country:US
Mailing Address - Phone:417-237-0604
Mailing Address - Fax:417-237-0613
Practice Address - Street 1:327 E AIRPORT DR
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-3402
Practice Address - Country:US
Practice Address - Phone:417-237-0604
Practice Address - Fax:417-237-0613
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-03
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO202212778363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily