=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194374959
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIE LLOYD CNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/05/2019
-----------------------------------------------------
Last Update Date | 11/23/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 153 COLLIER DR
-----------------------------------------------------
City | DOYLESTOWN
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44230-1208
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-658-1550
-----------------------------------------------------
Fax | 330-658-1699
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1193 NORTON AVE STE A
-----------------------------------------------------
City | NORTON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44203-9526
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-825-1152
-----------------------------------------------------
Fax | 330-854-0829
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 025574
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------