Provider Demographics
NPI:1184918765
Name:DERWART - REH, JULIE LYNN (CPM)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNN
Last Name:DERWART - REH
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-2040
Mailing Address - Country:US
Mailing Address - Phone:717-508-4852
Mailing Address - Fax:866-774-9271
Practice Address - Street 1:2 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-2040
Practice Address - Country:US
Practice Address - Phone:717-508-4852
Practice Address - Fax:186-677-4927
Is Sole Proprietor?:No
Enumeration Date:2011-06-01
Last Update Date:2014-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program