Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | OS 10966 | FL |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | OS 10966 | FL |
NPI | 1407067556 |
---|---|
Provider Name | Dr. Julie Nicole Chevillet |
First Address | Belfast, ME 04915-4005 |
Second Address | Melbourne, FL 32940-8299 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 15/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002497900 | (05) | FL |