Healthcare Provider Details

I. General information

NPI: 1063320638
Provider Name (Legal Business Name): JULIA ANN ILIFF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1044 23 RD
AXTELL NE
68924-3679
US

IV. Provider business mailing address

305 C AVE
AXTELL NE
68924-3412
US

V. Phone/Fax

Practice location:
  • Phone: 308-743-2401
  • Fax:
Mailing address:
  • Phone: 308-999-0242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: