MEDICARE: JULIA MCGUIRE

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1356284970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA MCGUIRE

Provider Business Mailing Address
First Line	:	7279 MOUSE CREEK RD NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37312-6306
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1023 PROVENANCE PL
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-7796
Country	:	US
Telephone Number	:	318-626-0100
Fax Number	:

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

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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Directions to “ JULIA MCGUIRE ” Practice Location

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