Provider Demographics
NPI:1285400655
Name:EDGELL, JULIE A
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:EDGELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8252 N SPIKER RD
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-8369
Mailing Address - Country:US
Mailing Address - Phone:937-214-4965
Mailing Address - Fax:
Practice Address - Street 1:8252 N SPIKER RD
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-8369
Practice Address - Country:US
Practice Address - Phone:937-214-4965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide