Provider Demographics
NPI:1982617387
Name:AULL, JULIE R (PA)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:R
Last Name:AULL
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:5200 COMMERCE CROSSINGS DR
Mailing Address - Street 2:FL 3
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229-2182
Mailing Address - Country:US
Mailing Address - Phone:502-778-0001
Mailing Address - Fax:502-776-1133
Practice Address - Street 1:234 AMY AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40212
Practice Address - Country:US
Practice Address - Phone:502-778-0001
Practice Address - Fax:502-776-1133
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2020-12-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9105820363A00000X
IN10000858A363A00000X
KYPA1182363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100009990Medicaid