1932149754 NPI number — JULIE SLIND HULL F.N.P.

Table of content: JULIE SLIND HULL F.N.P. (NPI 1932149754)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932149754 NPI number — JULIE SLIND HULL F.N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SLIND HULL
Provider First Name:
JULIE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
F.N.P.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CRANDALL
Provider Other First Name:
JULIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
F.N.P.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1932149754
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/19/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALEM
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97303-0900
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-399-2424
Provider Business Mailing Address Fax Number:
503-375-7429

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1165 UNION ST NE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
SALEM
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97301-4693
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-399-2424
Provider Business Practice Location Address Fax Number:
503-375-7429
Provider Enumeration Date:
06/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  NP292436 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 292436 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 110072746 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: CS4159 . This is a "RAILROAD GROUP" identifier . This identifiers is of the category "OTHER".




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