Provider Demographics
NPI:1083607634
Name:REECE, JULIANNA JEAN (MD)
Entity Type:Individual
Prefix:
First Name:JULIANNA
Middle Name:JEAN
Last Name:REECE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JULIANNA
Other - Middle Name:
Other - Last Name:MARTINEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:810 E 3RD ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-5728
Mailing Address - Country:US
Mailing Address - Phone:970-764-1790
Mailing Address - Fax:970-375-7927
Practice Address - Street 1:810 E 3RD ST
Practice Address - Street 2:SUITE 201
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5728
Practice Address - Country:US
Practice Address - Phone:970-764-1790
Practice Address - Fax:970-375-7927
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO55863207Q00000X
CAA81004207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH77419Medicare UPIN