Provider Demographics
NPI:1104075761
Name:SMELSER, JULI ANN (NP-C)
Entity type:Individual
Prefix:
First Name:JULI
Middle Name:ANN
Last Name:SMELSER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6349 JULIANNA LN
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43571-9067
Mailing Address - Country:US
Mailing Address - Phone:567-246-5165
Mailing Address - Fax:
Practice Address - Street 1:1650 EBER RD STE F
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-9793
Practice Address - Country:US
Practice Address - Phone:419-866-4328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.10187-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner