Healthcare Provider Details

I. General information

NPI: 1508694589
Provider Name (Legal Business Name): MS. JULIA LYNN RAHMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2024
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 553
MIDWAY WV
25878-0553
US

IV. Provider business mailing address

PO BOX 553
MIDWAY WV
25878-0553
US

V. Phone/Fax

Practice location:
  • Phone: 681-368-0039
  • Fax:
Mailing address:
  • Phone: 681-368-0039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW082417198
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: