Provider Demographics
NPI:1316726250
Name:BITTINGER, JULIE
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:BITTINGER
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 1:1376 E MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:WILEY FORD
Mailing Address - State:WV
Mailing Address - Zip Code:26767-9747
Mailing Address - Country:US
Mailing Address - Phone:301-697-6817
Mailing Address - Fax:
Practice Address - Street 1:1376 E MAPLE ST
Practice Address - Street 2:
Practice Address - City:WILEY FORD
Practice Address - State:WV
Practice Address - Zip Code:26767-9747
Practice Address - Country:US
Practice Address - Phone:301-697-6817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker