Healthcare Provider Details

I. General information

NPI: 1740779081
Provider Name (Legal Business Name): JULIE ANN CAMMON RINEHART CNM, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2018
Last Update Date: 05/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 CUSUMANO PROFESSIONAL PLAZA DR
MOUNT VERNON IL
62864-6736
US

IV. Provider business mailing address

504 N 27TH ST
MOUNT VERNON IL
62864-2924
US

V. Phone/Fax

Practice location:
  • Phone: 618-244-4800
  • Fax: 618-241-1746
Mailing address:
  • Phone: 256-443-5845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number209.017578
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: