Provider Demographics
NPI:1831498146
Name:RITLAND, JULIE LOUISE (ARNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LOUISE
Last Name:RITLAND
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 KINGBARD BLVD
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701-3056
Mailing Address - Country:US
Mailing Address - Phone:319-236-3641
Mailing Address - Fax:
Practice Address - Street 1:424 KINGBARD BLVD
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701-3056
Practice Address - Country:US
Practice Address - Phone:319-236-3641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAC-087306363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics