Healthcare Provider Details

I. General information

NPI: 1649586496
Provider Name (Legal Business Name): JULIA ANN HALL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2010
Last Update Date: 02/24/2022
Certification Date: 02/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 BUECHEL BANK RD AP4- 100B MEDICAL BUILDING
LOUISVILLE KY
40225
US

IV. Provider business mailing address

4000 BUECHEL BANK RD APT 4100B
LOUISVILLE KY
40225-0001
US

V. Phone/Fax

Practice location:
  • Phone: 502-452-0777
  • Fax: 866-287-5090
Mailing address:
  • Phone: 502-452-0777
  • Fax: 866-287-5090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3011697
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number28142728A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: