Provider Demographics
NPI:1689545667
Name:STEACY, JULIE (RN)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:STEACY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2596 LOWER CINCINNATUS RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATUS
Mailing Address - State:NY
Mailing Address - Zip Code:13040-9605
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2596 LOWER CINCINNATUS RD
Practice Address - Street 2:
Practice Address - City:CINCINNATUS
Practice Address - State:NY
Practice Address - Zip Code:13040-9605
Practice Address - Country:US
Practice Address - Phone:607-345-6059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY778407163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice