Provider Demographics
NPI:1831639251
Name:TREVINO, JULIA MARIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:MARIE
Last Name:TREVINO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:681 THOMAS ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43609-3351
Mailing Address - Country:US
Mailing Address - Phone:419-309-6188
Mailing Address - Fax:
Practice Address - Street 1:681 THOMAS ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43609-3351
Practice Address - Country:US
Practice Address - Phone:419-309-6188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-04
Last Update Date:2017-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN153003164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse