Provider Demographics
NPI:1891731329
Name:BILELLO, JULIE O (NP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:O
Last Name:BILELLO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1811 BAYOU BLACK DR
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-7346
Mailing Address - Country:US
Mailing Address - Phone:985-860-5130
Mailing Address - Fax:
Practice Address - Street 1:1811 BAYOU BLACK DR
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-7346
Practice Address - Country:US
Practice Address - Phone:985-860-5130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP03142363L00000X
TX818402363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1535982Medicaid
LA5X398Medicare PIN
LAS47889Medicare UPIN
LA3C5027627Medicare PIN