=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508880709
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIANNE OSSEGE APRN, PHD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/27/2006
-----------------------------------------------------
Last Update Date | 06/08/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 317 E MAIN ST
-----------------------------------------------------
City | WILMORE
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40390-1323
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-858-0339
-----------------------------------------------------
Fax | 859-858-0341
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7495 STATE RD SUITE 350
-----------------------------------------------------
City | CINCINNATI
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45255-2498
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 513-229-9121
-----------------------------------------------------
Fax | 513-231-0337
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207K00000X
-----------------------------------------------------
Taxonomy Name | Allergy & Immunology Physician
-----------------------------------------------------
License Number | 178451
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 3001813
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------