Healthcare Provider Details

I. General information

NPI: 1225098338
Provider Name (Legal Business Name): JULIE ANNE DEARMITT LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1608 HILLSIDE RD
CAMBRIDGE WI
53523-9603
US

IV. Provider business mailing address

717 W RACINE ST
JANESVILLE WI
53548-5151
US

V. Phone/Fax

Practice location:
  • Phone: 608-423-3489
  • Fax:
Mailing address:
  • Phone: 608-758-0604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: