Healthcare Provider Details

I. General information

NPI: 1972524254
Provider Name (Legal Business Name): JULIA E ABRAHAM CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 02/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 E MARKET ST
WARREN OH
44483-6608
US

IV. Provider business mailing address

2000 E LAMAR BLVD SUITE 400
ARLINGTON TX
76006-7346
US

V. Phone/Fax

Practice location:
  • Phone: 330-841-9011
  • Fax:
Mailing address:
  • Phone: 682-227-6838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN355452L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCOA.02493-NA
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN.180963-NA
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: