MEDICARE: DR. JULIE A JARRELL AU.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	2201001389	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2201001389	OTHER	VA	VIRGINIA STATE AUDIOLOGY LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366551129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIE A JARRELL AU.D.

Provider Business Mailing Address
First Line	:	3900 DONNINGTON DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-5769
Country	:	US
Telephone Number	:	757-689-0866
Fax Number	:

Provider Business Practice Location Address
First Line	:	3900 DONNINGTON DR
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23456-5769
Country	:	US
Telephone Number	:	757-689-0866
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	02/13/2015

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