Provider Demographics
NPI:1992055347
Name:BURD, JULIE M (LPN)
Entity type:Individual
Prefix:MISS
First Name:JULIE
Middle Name:M
Last Name:BURD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 W GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:OH
Mailing Address - Zip Code:44672-1925
Mailing Address - Country:US
Mailing Address - Phone:330-206-6094
Mailing Address - Fax:
Practice Address - Street 1:489 W GEORGIA AVE
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:OH
Practice Address - Zip Code:44672-1925
Practice Address - Country:US
Practice Address - Phone:330-206-6094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH137933MIV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse