Healthcare Provider Details

I. General information

NPI: 1285779843
Provider Name (Legal Business Name): JULIANN M SCHLEUDER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 06/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

890 W ELLIOT RD SUITE 102
GILBERT AZ
85233-5102
US

IV. Provider business mailing address

1492 S MILL AVE STE 301
TEMPE AZ
85281-5676
US

V. Phone/Fax

Practice location:
  • Phone: 480-545-2787
  • Fax: 919-882-9575
Mailing address:
  • Phone: 480-894-5550
  • Fax: 480-894-9469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number1274
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5522
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: