Healthcare Provider Details

I. General information

NPI: 1033561188
Provider Name (Legal Business Name): JULIA LEE ECHOLS MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2016
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11260 E JEFFERSON AVE
DETROIT MI
48214-3320
US

IV. Provider business mailing address

PO BOX 746723
ATLANTA GA
30374-6723
US

V. Phone/Fax

Practice location:
  • Phone: 313-306-5494
  • Fax:
Mailing address:
  • Phone: 127-339-7303
  • Fax: 773-866-8014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704186764
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: