Provider Demographics
NPI:1285779843
Name:SCHLEUDER, JULIANN M (PA)
Entity type:Individual
Prefix:
First Name:JULIANN
Middle Name:M
Last Name:SCHLEUDER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1492 S MILL AVE
Mailing Address - Street 2:STE 301
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-5676
Mailing Address - Country:US
Mailing Address - Phone:480-894-5550
Mailing Address - Fax:480-894-9469
Practice Address - Street 1:890 W ELLIOT RD
Practice Address - Street 2:SUITE 102
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-5102
Practice Address - Country:US
Practice Address - Phone:480-545-2787
Practice Address - Fax:919-882-9575
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA1274363AM0700X
AZ5522363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0076372Medicaid
IDP03971Medicare PIN