Provider Demographics
NPI:1851766729
Name:SHELL, JULIE (LPN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:SHELL
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 1:70 W ERIE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-3278
Mailing Address - Country:US
Mailing Address - Phone:440-352-0137
Mailing Address - Fax:
Practice Address - Street 1:70 W ERIE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-3278
Practice Address - Country:US
Practice Address - Phone:440-352-0137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-03
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-140794-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse