=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508948373
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SUSAN B. JULIAN C.N.P.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/20/2006
-----------------------------------------------------
Last Update Date | 02/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10306 W 950 S
-----------------------------------------------------
City | LOSANTVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47354-9416
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-530-8008
-----------------------------------------------------
Fax | 765-530-8099
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 193
-----------------------------------------------------
City | LOSANTVILLE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 47354-0193
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-530-8008
-----------------------------------------------------
Fax | 765-530-8099
-----------------------------------------------------
=====================================================
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 | 71001904A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------