Provider Demographics
NPI:1033622667
Name:BISE, JULIE ANN (RN CAPS CBIS)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:BISE
Suffix:
Gender:F
Credentials:RN CAPS CBIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10555 ENTERPRISE DR STE 314
Mailing Address - Street 2:
Mailing Address - City:DAVISBURG
Mailing Address - State:MI
Mailing Address - Zip Code:48350-1338
Mailing Address - Country:US
Mailing Address - Phone:248-866-8622
Mailing Address - Fax:248-922-5709
Practice Address - Street 1:10555 ENTERPRISE DR STE 314
Practice Address - Street 2:
Practice Address - City:DAVISBURG
Practice Address - State:MI
Practice Address - Zip Code:48350-1338
Practice Address - Country:US
Practice Address - Phone:248-866-8622
Practice Address - Fax:248-922-5709
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-06
Last Update Date:2017-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704200772163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Single Specialty