Healthcare Provider Details

I. General information

NPI: 1508880709
Provider Name (Legal Business Name): JULIANNE OSSEGE APRN, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 06/08/2022
Certification Date: 06/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 E MAIN ST
WILMORE KY
40390-1323
US

IV. Provider business mailing address

7495 STATE RD SUITE 350
CINCINNATI OH
45255-2498
US

V. Phone/Fax

Practice location:
  • Phone: 859-858-0339
  • Fax: 859-858-0341
Mailing address:
  • Phone: 513-229-9121
  • Fax: 513-231-0337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number178451
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3001813
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: