Provider Demographics
NPI:1164443834
Name:HAASE, JULIE H
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:H
Last Name:HAASE
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:L
Other - Last Name:HRUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-777-0376
Mailing Address - Fax:414-777-0033
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-777-0376
Practice Address - Fax:414-777-0033
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI876982133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered