Julie Antonette Koob, LPN

Individual provider Active NPI Licensed Practical Nurse · Vail, AZ

NPI 1992123152 · NPPES record last updated Apr 3, 2014

Key facts

NPI
1992123152
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
27069194A (IN)
Practice address
1990 N Calle Rinconado
Vail, AZ 85641-9328
Phone
(520) 286-5707
NPI assigned
Apr 3, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
27069194AINMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 27069194A IN Yes

Addresses

Primary practice location

1990 N Calle Rinconado
Vail, AZ 85641-9328

Mailing address

1990 N Calle Rinconado
Vail, AZ 85641-9328
Phone (520) 286-5707

Other providers in Vail, AZ

All providers in Vail, AZ · Licensed Practical Nurse in Arizona

Sources for this page

Verify at the official NPI Registry.