MEDICARE: JULIE C ANDERSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant
2	171M00000X	Case Manager/Care Coordinator		OH

General Provider Information

NPI Number	:	1043041106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE C ANDERSON

Provider Business Mailing Address
First Line	:	979 COPLEY RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44320-2856
Country	:	US
Telephone Number	:	330-356-3735
Fax Number	:

Provider Business Practice Location Address
First Line	:	979 COPLEY RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44320-2856
Country	:	US
Telephone Number	:	330-356-3735
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2024
Last Update Date	:	09/18/2024

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Directions to “ JULIE C ANDERSON ” Practice Location

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