MEDICARE: JULIA KAY AILTS APRN-CNP, RN

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	163WP0808X	Psychiatric/Mental Health Registered Nurse	RN.465609	OH
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.0034662	OH

General Provider Information

NPI Number	:	1881375061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA KAY AILTS APRN-CNP, RN

Provider Business Mailing Address
First Line	:	4470 INDIANOLA AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-2244
Country	:	US
Telephone Number	:	614-371-2303
Fax Number	:	800-905-9950

Provider Business Practice Location Address
First Line	:	4470 INDIANOLA AVE STE 107
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43214-2244
Country	:	US
Telephone Number	:	614-371-2303
Fax Number	:	800-905-9950

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

Provider Enumeration Date	:	07/31/2023
Last Update Date	:	11/07/2023

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