Provider Demographics
NPI:1013064187
Name:SCHANNO, JULIE ELIZABETH (MSN)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ELIZABETH
Last Name:SCHANNO
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-3361
Mailing Address - Country:US
Mailing Address - Phone:252-338-5183
Mailing Address - Fax:252-338-5669
Practice Address - Street 1:100 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-3361
Practice Address - Country:US
Practice Address - Phone:252-338-5183
Practice Address - Fax:252-338-5669
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2592470Medicare ID - Type Unspecified
NCQ55218Medicare UPIN