Provider Demographics
NPI:1003896069
Name:MCDONALD, JULIE M (CNM)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1151 ROBESON ST STE 201
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-5566
Mailing Address - Country:US
Mailing Address - Phone:508-730-1666
Mailing Address - Fax:508-646-7119
Practice Address - Street 1:1151 ROBESON ST STE 201
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5566
Practice Address - Country:US
Practice Address - Phone:508-730-1666
Practice Address - Fax:508-646-7119
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2020-04-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA193379367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0701971Medicaid
S73930Medicare UPIN