Provider Demographics
NPI:1134471022
Name:BEHNKE, JULIE MARIE (RN, CPNP)
Entity Type:Individual
Prefix:PROF
First Name:JULIE
Middle Name:MARIE
Last Name:BEHNKE
Suffix:
Gender:F
Credentials:RN, CPNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:32100 TELEGRAPH RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BINGHAM FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48025-2452
Mailing Address - Country:US
Mailing Address - Phone:248-644-1221
Mailing Address - Fax:248-644-2748
Practice Address - Street 1:32100 TELEGRAPH RD
Practice Address - Street 2:SUITE 110
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-2452
Practice Address - Country:US
Practice Address - Phone:248-644-1221
Practice Address - Fax:248-644-2748
Is Sole Proprietor?:No
Enumeration Date:2012-10-03
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704256676363LP0200X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care