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NPI Code Detail

MEDICARE: JULIE WHITE BA

MEDICARE: JULIE WHITE BA
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1962916361
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE WHITE BA
Provider Business Mailing Address
First Line : 313 HUDGINS ST
Second Line :
City : LOGAN
State : WV
Zip : 25601-3535
Country : US
Telephone Number : 304-752-7830
Fax Number :
Provider Business Practice Location Address
First Line : 313 HUDGINS ST
Second Line :
City : LOGAN
State : WV
Zip : 25601-3535
Country : US
Telephone Number : 304-752-7830
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2017
Last Update Date : 11/21/2017

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Directions to “ JULIE WHITE BA” Practice Location

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