Healthcare Provider Details

I. General information

NPI: 1831113299
Provider Name (Legal Business Name): JULIE L CALLAN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE L LAUX CRNA

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13808 PROFESSIONAL CENTER DR
HUNTERSVILLE NC
28078-7948
US

IV. Provider business mailing address

13808 PROFESSIONAL CENTER DR
HUNTERSVILLE NC
28078-7948
US

V. Phone/Fax

Practice location:
  • Phone: 704-377-4009
  • Fax:
Mailing address:
  • Phone: 704-377-4009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4704217122
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number5573
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: