Provider Demographics
NPI:1780059741
Name:PRATER, JULIE (LPN)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:PRATER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45146 MCKENZIE HWY
Mailing Address - Street 2:
Mailing Address - City:LEABURG
Mailing Address - State:OR
Mailing Address - Zip Code:97489-9634
Mailing Address - Country:US
Mailing Address - Phone:828-553-7936
Mailing Address - Fax:
Practice Address - Street 1:151 W 7TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-1100
Practice Address - Country:US
Practice Address - Phone:541-682-3552
Practice Address - Fax:541-682-3551
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-02
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201407882164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse