Provider Demographics
NPI:1851308100
Name:SANKO, JULIE A (PA-C)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:SANKO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1118 BURLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HOLDREGE
Mailing Address - State:NE
Mailing Address - Zip Code:68949-1705
Mailing Address - Country:US
Mailing Address - Phone:308-995-3760
Mailing Address - Fax:308-995-3775
Practice Address - Street 1:1118 BURLINGTON ST
Practice Address - Street 2:
Practice Address - City:HOLDREGE
Practice Address - State:NE
Practice Address - Zip Code:68949-1705
Practice Address - Country:US
Practice Address - Phone:308-995-3760
Practice Address - Fax:308-995-3775
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE713363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE713OtherSTATE LICENSE
970030826OtherRAILROAD MEDICARE
283821AOtherRURAL HEALTH
NE713OtherSTATE LICENSE
283821AOtherRURAL HEALTH
273764Medicare PIN