Provider Demographics
NPI:1215925268
Name:SANDELL, JULIE RENEE (DO,FP)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:RENEE
Last Name:SANDELL
Suffix:
Gender:F
Credentials:DO,FP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 BLUEBELL RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-6328
Mailing Address - Country:US
Mailing Address - Phone:319-575-5800
Mailing Address - Fax:319-575-5855
Practice Address - Street 1:226 BLUEBELL RD
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-6328
Practice Address - Country:US
Practice Address - Phone:319-575-5800
Practice Address - Fax:319-575-5855
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03168207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA3154674Medicaid
IA3154674Medicaid
IA3154674Medicaid