Provider Demographics
NPI:1093804023
Name:DONAHUE, JULIE M (NP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:DONAHUE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 S PARKER RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1622
Mailing Address - Country:US
Mailing Address - Phone:303-338-4545
Mailing Address - Fax:
Practice Address - Street 1:2550 S PARKER RD
Practice Address - Street 2:SUITE 220
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1622
Practice Address - Country:US
Practice Address - Phone:303-338-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO125873363LP1700X, 364SX0204X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LP1700XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPerinatal
No364SX0204XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology, Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO809609OtherMEDICARE GROUP PTAN
CO59931744OtherMEDICAID GROUP NUMBER
CO88150062OtherMEDICAID GROUP PRACTICE #
CO25801872Medicaid
CO348308OtherMEDICARE GROUP NUMBER
CO809609OtherMEDICARE GROUP PTAN
CO348308OtherMEDICARE GROUP NUMBER