Provider Demographics
NPI:1548065923
Name:CVICKER, JULIA KATHERINE
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:KATHERINE
Last Name:CVICKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2028 PRAIRIE AVE # A
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-3136
Mailing Address - Country:US
Mailing Address - Phone:503-979-3659
Mailing Address - Fax:
Practice Address - Street 1:2028 PRAIRIE AVE # A
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-3136
Practice Address - Country:US
Practice Address - Phone:503-979-3659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
146D00000X, 372500000X, 372600000X, 3747A0650X, 3747P1801X, 374U00000X, 376J00000X
WI383842376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker