Individual
MRS. JULIE ANNE ADDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
53830 GENERATIONS DR, SOUTH BEND, IN 46635-1543
(574) 271-0893
Mailing address
17501 GENERATIONS DR, SOUTH BEND, IN 46635-1589
(574) 234-0049
(574) 234-0053
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
051170
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
28182698A
IN
Other
Enumeration date
08/29/2006
Last updated
02/18/2015
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