Provider Demographics
NPI:1013549617
Name:EDWARDS, JULIE M (MSN, RN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 LOST LAKE PL UNIT G1
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80528-7055
Mailing Address - Country:US
Mailing Address - Phone:970-404-7147
Mailing Address - Fax:
Practice Address - Street 1:3450 LOST LAKE PL UNIT G1
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80528-7055
Practice Address - Country:US
Practice Address - Phone:970-404-7147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-11
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1664534163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse