Healthcare Provider Details

I. General information

NPI: 1821455254
Provider Name (Legal Business Name): JULIE RHULE AGACNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2016
Last Update Date: 04/06/2022
Certification Date: 04/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 MEDICAL CENTER BLVD
LAWRENCEVILLE GA
30046-7694
US

IV. Provider business mailing address

PO BOX 1746
INDIANAPOLIS IN
46206-1746
US

V. Phone/Fax

Practice location:
  • Phone: 404-634-9196
  • Fax: 678-312-5288
Mailing address:
  • Phone: 877-383-4442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN-150123
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: