Healthcare Provider Details

I. General information

NPI: 1477731735
Provider Name (Legal Business Name): JULIE LYN DANIELS CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE LYN WILLIAMS CNM

II. Dates (important events)

Enumeration Date: 02/08/2008
Last Update Date: 03/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 KATE IRELAND DRIVE
HYDEN KY
41749
US

IV. Provider business mailing address

130 KATE IRELAND DRIVE
HYDEN KY
41749
US

V. Phone/Fax

Practice location:
  • Phone: 606-672-2901
  • Fax: 606-672-2851
Mailing address:
  • Phone: 606-672-2901
  • Fax: 606-672-2851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number6041M
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number4704172420
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: