Healthcare Provider Details

I. General information

NPI: 1295679629
Provider Name (Legal Business Name): MS. JULIE J CALDWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1235 E CHEROKEE ST
SPRINGFIELD MO
65804-2203
US

IV. Provider business mailing address

411 E MITCHELL CT
REPUBLIC MO
65738-2675
US

V. Phone/Fax

Practice location:
  • Phone: 417-820-3251
  • Fax: 417-820-8299
Mailing address:
  • Phone: 417-421-5544
  • Fax: 417-820-8299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number043036
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: