Provider Demographics
NPI:1972809119
Name:PRIESTLEY, JULIA (PHARM D)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:PRIESTLEY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:PRIESTLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARM D
Mailing Address - Street 1:PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE CENTER
Mailing Address - State:IA
Mailing Address - Zip Code:50115-0099
Mailing Address - Country:US
Mailing Address - Phone:641-747-8317
Mailing Address - Fax:641-747-3217
Practice Address - Street 1:307 STATE ST
Practice Address - Street 2:
Practice Address - City:GUTHRIE CENTER
Practice Address - State:IA
Practice Address - Zip Code:50115-1351
Practice Address - Country:US
Practice Address - Phone:641-747-8317
Practice Address - Fax:641-747-3217
Is Sole Proprietor?:No
Enumeration Date:2011-02-06
Last Update Date:2011-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19841183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist