Basic Information
Provider Information
NPI: 1801150123
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LE LEUX
FirstName: JULIE
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: EWAYS
OtherFirstName: JULIE
OtherMiddleName: M
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 15133
Address2:  
City: DURHAM
State: NC
PostalCode: 277040133
CountryCode: US
TelephoneNumber: 9194775152
FaxNumber: 9194775474
Practice Location
Address1: 3643 N ROXBORO ST
Address2:  
City: DURHAM
State: NC
PostalCode: 277042702
CountryCode: US
TelephoneNumber: 9194704000
FaxNumber: 9194775474
Other Information
ProviderEnumerationDate: 07/02/2012
LastUpdateDate: 03/17/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X5005675NCY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


Home