MEDICARE: JULIE ANN HARVIELL

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

General Provider Information

NPI Number	:	1902494248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE ANN HARVIELL

Provider Business Mailing Address
First Line	:	104 FAWCETT ST NW # 331
Second Line	:
City	:	SAINT JOHN
State	:	ND
Zip	:	58369-6901
Country	:	US
Telephone Number	:	701-550-1732
Fax Number	:

Provider Business Practice Location Address
First Line	:	104 FAWCETT ST NW
Second Line	:
City	:	SAINT JOHN
State	:	ND
Zip	:	58369-6901
Country	:	US
Telephone Number	:	701-550-1732
Fax Number	:

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

Provider Enumeration Date	:	01/04/2021
Last Update Date	:	01/04/2021

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