MEDICARE: JULIE LARAE HEDMAN APRN

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	363LF0000X	Family Nurse Practitioner	75435	KS
2	363LF0000X	Family Nurse Practitioner	114642	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518245646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE LARAE HEDMAN APRN

Provider Business Mailing Address
First Line	:	2334 SE WASHINGTON BLVD
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-7256
Country	:	US
Telephone Number	:	918-213-4619
Fax Number	:

Provider Business Practice Location Address
First Line	:	2334 SE WASHINGTON BLVD
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006-7256
Country	:	US
Telephone Number	:	918-213-4619
Fax Number	:

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

Provider Enumeration Date	:	07/22/2011
Last Update Date	:	11/17/2021

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