Provider Demographics
NPI:1164476073
Name:WAUGH, JULIE A (NP)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:A
Last Name:WAUGH
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:DIVISION OF NEOPLASTIC DISEASES
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-6800
Mailing Address - Fax:414-805-6805
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:DIVISION OF NEOPLASTIC DISEASES
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-6800
Practice Address - Fax:414-805-6805
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2013-02-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI1389-033363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
006000215QOtherHUMANA
WI1164476073Medicaid
WI022K 73-601Medicare PIN
S84054Medicare UPIN