Provider Demographics
NPI:1003404880
Name:BAUTE, JULIE J (APRN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:J
Last Name:BAUTE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 CANTON RD NE STE 205
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-7242
Mailing Address - Country:US
Mailing Address - Phone:678-224-6198
Mailing Address - Fax:
Practice Address - Street 1:780 CANTON RD NE STE 205
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-7242
Practice Address - Country:US
Practice Address - Phone:678-224-6198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN144580363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner