Provider Demographics
NPI:1952549727
Name:JOCHUM, JULIE LAURA (OD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:LAURA
Last Name:JOCHUM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 O ST 100
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68508-1440
Mailing Address - Country:US
Mailing Address - Phone:402-476-7583
Mailing Address - Fax:402-476-7761
Practice Address - Street 1:1751 MADISON AVE
Practice Address - Street 2:#200
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-5246
Practice Address - Country:US
Practice Address - Phone:712-322-2333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-01
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002470152W00000X
NE1330152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist