1992172183 NPI number — JULIE JEREE MCCLEESE CPHT

Table of content: JULIE JEREE MCCLEESE CPHT (NPI 1992172183)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992172183 NPI number — JULIE JEREE MCCLEESE CPHT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCLEESE
Provider First Name:
JULIE
Provider Middle Name:
JEREE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CPHT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992172183
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/24/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2880 BICENTENNIAL PARKWAY
Provider Second Line Business Mailing Address:
STE 100 #114
Provider Business Mailing Address City Name:
HENDERSON
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89044-4484
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-343-8173
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8285 W ARBY AVE
Provider Second Line Business Practice Location Address:
HEALTHCARE PARTNERS
Provider Business Practice Location Address City Name:
LAS VEGAS
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89113
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-735-7154
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/24/2015

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: 183700000X , with the licence number:  PT13925 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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