Provider Demographics
NPI:1922340587
Name:LIFE, JULIA LYNN (RN)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:LYNN
Last Name:LIFE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 WINDRUSH LN
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17055-9236
Mailing Address - Country:US
Mailing Address - Phone:717-580-1577
Mailing Address - Fax:717-790-0828
Practice Address - Street 1:113 WINDRUSH LN
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-9236
Practice Address - Country:US
Practice Address - Phone:717-580-1577
Practice Address - Fax:717-790-0828
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN305594L163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator