Provider Demographics
NPI:1053485227
Name:JAVERNICK, JULIE A (CNM)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:A
Last Name:JAVERNICK
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7950 KIPLING ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80005
Mailing Address - Country:US
Mailing Address - Phone:303-424-6466
Mailing Address - Fax:303-420-8944
Practice Address - Street 1:7950 KIPLING ST
Practice Address - Street 2:SUITE 201
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80005
Practice Address - Country:US
Practice Address - Phone:303-424-6466
Practice Address - Fax:303-420-8944
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COCO 112468367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO90555341Medicaid