Provider Demographics
NPI:1114907540
Name:ROLSTAD, JULIE M (RN, ANP-BC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:ROLSTAD
Suffix:
Gender:F
Credentials:RN, ANP-BC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:MARIE
Other - Last Name:WESTLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:MN
Mailing Address - Zip Code:56031-4575
Mailing Address - Country:US
Mailing Address - Phone:507-238-8100
Mailing Address - Fax:507-238-8522
Practice Address - Street 1:800 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:MN
Practice Address - Zip Code:56031-4575
Practice Address - Country:US
Practice Address - Phone:507-238-8100
Practice Address - Fax:507-238-8522
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4750363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
S75151Medicare UPIN
MO426197604Medicaid
F06C105BMedicare ID - Type Unspecified