Healthcare Provider Details

I. General information

NPI: 1730325580
Provider Name (Legal Business Name): JULIE NELSON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIE TOMNAY DO

II. Dates (important events)

Enumeration Date: 12/29/2008
Last Update Date: 11/03/2020
Certification Date: 11/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4044 ROUTE 130 STE 200
IRWIN PA
15642-7830
US

IV. Provider business mailing address

3824 NORTHERN PIKE STE 700
MONROEVILLE PA
15146-2141
US

V. Phone/Fax

Practice location:
  • Phone: 724-744-2500
  • Fax: 724-744-3338
Mailing address:
  • Phone: 412-457-0060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOT011742
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: