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NPI Code Detail

MEDICARE: JULIE CLOUGHERTY RN

MEDICARE: JULIE CLOUGHERTY RN
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
1163WH0200XHome Health Registered Nurse719329-01NY

General Provider Information

NPI Number : 1952246845
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE CLOUGHERTY RN
Provider Business Mailing Address
First Line : 163 YAPLE RD
Second Line :
City : ITHACA
State : NY
Zip : 14850-8628
Country : US
Telephone Number : 607-252-7469
Fax Number : 607-277-1494
Provider Business Practice Location Address
First Line : 138 CECIL MALONE DR
Second Line :
City : ITHACA
State : NY
Zip : 14850-5124
Country : US
Telephone Number : 607-252-7469
Fax Number : 607-277-1494
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2026
Last Update Date : 04/20/2026

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