Healthcare Provider Details

I. General information

NPI: 1659205151
Provider Name (Legal Business Name): JULIE HOM RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6730 ROOSEVELT AVE STE 301
MIDDLETOWN OH
45005-5736
US

IV. Provider business mailing address

11957 STATE ROUTE 122
CAMDEN OH
45311-8866
US

V. Phone/Fax

Practice location:
  • Phone: 513-928-3339
  • Fax:
Mailing address:
  • Phone: 513-292-2543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number445292
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: