Provider Demographics
NPI:1124454483
Name:ASHBROOK DEERING, JULIE VALINDA
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:VALINDA
Last Name:ASHBROOK DEERING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 S. WEAVER ST.
Mailing Address - Street 2:
Mailing Address - City:HESSTON
Mailing Address - State:KS
Mailing Address - Zip Code:67062
Mailing Address - Country:US
Mailing Address - Phone:620-217-9122
Mailing Address - Fax:
Practice Address - Street 1:205 S WEAVER ST
Practice Address - Street 2:
Practice Address - City:HESSTON
Practice Address - State:KS
Practice Address - Zip Code:67062-8931
Practice Address - Country:US
Practice Address - Phone:620-217-9122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS76094363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily