Provider Demographics
NPI:1255050647
Name:KROSS, JULIE B
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:B
Last Name:KROSS
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 1:2512 COUNTY ROAD 561
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37303-6383
Mailing Address - Country:US
Mailing Address - Phone:865-973-1935
Mailing Address - Fax:
Practice Address - Street 1:2512 COUNTY ROAD 561
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-6383
Practice Address - Country:US
Practice Address - Phone:865-973-1935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist