Healthcare Provider Details

I. General information

NPI: 1689545667
Provider Name (Legal Business Name): JULIE STEACY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 CALVARY DR
NORWICH NY
13815-1032
US

IV. Provider business mailing address

55 CALVARY DR
NORWICH NY
13815-1032
US

V. Phone/Fax

Practice location:
  • Phone: 607-336-6362
  • Fax:
Mailing address:
  • Phone: 607-336-6362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number778407
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF358015
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: