Healthcare Provider Details

I. General information

NPI: 1356994073
Provider Name (Legal Business Name): JULIA WILSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIA GUARD

II. Dates (important events)

Enumeration Date: 07/22/2019
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 WILSON CREEK RD
LAWRENCEBURG IN
47025-2751
US

IV. Provider business mailing address

P.O. BOX 636324
CINCINNATI OH
45263-6324
US

V. Phone/Fax

Practice location:
  • Phone: 812-496-4910
  • Fax: 812-532-2664
Mailing address:
  • Phone: 859-344-5555
  • Fax: 859-344-5552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3018984
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71013876A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberCNP025496
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: