Provider Demographics
NPI:1649419912
Name:HENRY, JULIE ANN (ARNP)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANN
Last Name:HENRY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7450 S MASON MONTGOMERY RD UNIT 200
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-8080
Mailing Address - Country:US
Mailing Address - Phone:513-585-2410
Mailing Address - Fax:513-792-7807
Practice Address - Street 1:7450 S MASON MONTGOMERY RD UNIT 200
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-8080
Practice Address - Country:US
Practice Address - Phone:513-585-2410
Practice Address - Fax:513-792-7807
Is Sole Proprietor?:No
Enumeration Date:2009-02-11
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1083909163W00000X
KY3005891363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100146640Medicaid
OH0156800Medicaid
KYK175860Medicare PIN
KY7100146640Medicaid