Provider Demographics
NPI:1902618614
Name:REA, JULIE A
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:REA
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:PO BOX 144
Mailing Address - Street 2:
Mailing Address - City:MC COOL JUNCTION
Mailing Address - State:NE
Mailing Address - Zip Code:68401-0144
Mailing Address - Country:US
Mailing Address - Phone:402-710-0713
Mailing Address - Fax:
Practice Address - Street 1:202 N KLINZMAN AVE
Practice Address - Street 2:
Practice Address - City:MC COOL JUNCTION
Practice Address - State:NE
Practice Address - Zip Code:68401-3027
Practice Address - Country:US
Practice Address - Phone:402-710-0713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant