Basic Information
| Provider Information | |||||||||
| NPI: | 1417943358 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EGLI | ||||||||
| FirstName: | JULIA | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3014 | ||||||||
| Address2: | 1215 DUFF AVENUE | ||||||||
| City: | AMES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 500103014 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5158326700 | ||||||||
| FaxNumber: | 5158323534 | ||||||||
| Practice Location | |||||||||
| Address1: | 510 BANK STREET | ||||||||
| Address2: | |||||||||
| City: | WEBSTER CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 50595 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5158326700 | ||||||||
| FaxNumber: | 5158323534 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2005 | ||||||||
| LastUpdateDate: | 01/23/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA195363 | OR | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | 1243 | IA | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.