Provider Demographics
NPI:1730421322
Name:BISSETT, JULIA ALLEGRA (MSN, APRN, PMHNP-BC)
Entity type:Individual
Prefix:MS
First Name:JULIA
Middle Name:ALLEGRA
Last Name:BISSETT
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:MS
Other - First Name:JULIA
Other - Middle Name:ALLEGRA
Other - Last Name:VERES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, APRN, PMHNP-BC
Mailing Address - Street 1:5350 TRANSPORTATION BLVD STE 22
Mailing Address - Street 2:
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-5307
Mailing Address - Country:US
Mailing Address - Phone:216-435-1110
Mailing Address - Fax:216-472-8996
Practice Address - Street 1:5350 TRANSPORTATION BLVD STE 22
Practice Address - Street 2:
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-5307
Practice Address - Country:US
Practice Address - Phone:216-435-1110
Practice Address - Fax:216-472-8996
Is Sole Proprietor?:No
Enumeration Date:2013-03-21
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.372209163WP0808X
OHCOA.15807-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2871101Medicaid