Provider Demographics
NPI:1902492259
Name:STANBERRY, JULIA ELIZABETH (LPN)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ELIZABETH
Last Name:STANBERRY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 MURPHY AVE
Mailing Address - Street 2:
Mailing Address - City:WINTERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43953-4215
Mailing Address - Country:US
Mailing Address - Phone:740-457-8218
Mailing Address - Fax:
Practice Address - Street 1:1479 3RD ST
Practice Address - Street 2:
Practice Address - City:BRILLIANT
Practice Address - State:OH
Practice Address - Zip Code:43913-1000
Practice Address - Country:US
Practice Address - Phone:405-982-0547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.162829.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse