Healthcare Provider Details

I. General information

NPI: 1821524190
Provider Name (Legal Business Name): JULIA EDMONDSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2017
Last Update Date: 06/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

8392 WYCLIFFE DR
CINCINNATI OH
45244-2596
US

V. Phone/Fax

Practice location:
  • Phone: 513-803-7630
  • Fax:
Mailing address:
  • Phone: 513-828-2244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.18748
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License NumberRN 320070
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: