Provider Demographics
NPI:1114996998
Name:UNRUH, JULIE ANNE (APRN, FNP)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANNE
Last Name:UNRUH
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19837 TALKING ROCK HTS
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-3449
Mailing Address - Country:US
Mailing Address - Phone:760-429-8362
Mailing Address - Fax:
Practice Address - Street 1:9475 BRIAR VILLAGE PT STE 225
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7919
Practice Address - Country:US
Practice Address - Phone:719-377-3477
Practice Address - Fax:760-267-9162
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2021-06-22
Deactivation Date:2020-11-03
Deactivation Code:
Reactivation Date:2020-11-24
Provider Licenses
StateLicense IDTaxonomies
CO0990719363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO100681OtherAPRN RXP
CO0990719OtherAPRN LICENSE
CO100681OtherAPRN RXP
CO100681OtherAPRN RXP
CA18606OtherCALIFORNIA NURSE PRACTITIONER
CABI918ZMedicare PIN