Provider Demographics
NPI:1831302454
Name:MEYERS, JULIE J (APNC-APNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:J
Last Name:MEYERS
Suffix:
Gender:F
Credentials:APNC-APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23122 WHITEHALL RD
Mailing Address - Street 2:PO BOX 125
Mailing Address - City:INDEPENDENCE
Mailing Address - State:WI
Mailing Address - Zip Code:54747-7702
Mailing Address - Country:US
Mailing Address - Phone:715-538-2306
Mailing Address - Fax:715-538-2278
Practice Address - Street 1:18520 SCRANTON ST
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:WI
Practice Address - Zip Code:54773-8521
Practice Address - Country:US
Practice Address - Phone:715-538-2306
Practice Address - Fax:715-538-2278
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1455-033363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner