Provider Demographics
NPI:1184097859
Name:MITCHELL, JULIANA (FNP-C)
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JULIANA
Other - Middle Name:
Other - Last Name:KLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12623 ECKEL JUNCTION RD STE 2600
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-1304
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12623 ECKEL JUNCTION RD STE 2600
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-1304
Practice Address - Country:US
Practice Address - Phone:537-368-1490
Practice Address - Fax:537-368-1478
Is Sole Proprietor?:No
Enumeration Date:2015-11-03
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041459965163W00000X
OHRN.361432163W00000X
IL209017188363LF0000X
OHCOA.18322-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse