Basic Information
| Provider Information | |||||||||
| NPI: | 1578557542 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STAUSMIRE | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | CNS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2200 JEFFERSON AVE | ||||||||
| Address2: | 4TH FLOOR | ||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436241120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192512673 | ||||||||
| FaxNumber: | 4192510916 | ||||||||
| Practice Location | |||||||||
| Address1: | 2702 NAVARRE AVE | ||||||||
| Address2: | SUITE 206 | ||||||||
| City: | OREGON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436163223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4196966000 | ||||||||
| FaxNumber: | 4196916018 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SA2200X | NS07771 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Adult Health |
No ID Information.