Healthcare Provider Details

I. General information

NPI: 1174645915
Provider Name (Legal Business Name): JULIA M. FINE FNP, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 03/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 W HILLSIDE AVE
SPENCER IN
47460-1119
US

IV. Provider business mailing address

PO BOX 393
GREENCASTLE IN
46135-0393
US

V. Phone/Fax

Practice location:
  • Phone: 812-829-0303
  • Fax: 812-829-0303
Mailing address:
  • Phone: 765-653-6171
  • Fax: 765-653-6171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71002255A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: