Provider Demographics
NPI:1184201451
Name:RUSSELL, JULIE MARIE (APRN-CNM)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:APRN-CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1805 SHEA CENTER DR STE 301
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDS RANCH
Mailing Address - State:CO
Mailing Address - Zip Code:80129-2277
Mailing Address - Country:US
Mailing Address - Phone:303-738-1100
Mailing Address - Fax:303-738-1310
Practice Address - Street 1:7780 S BROADWAY STE 280
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80122-2633
Practice Address - Country:US
Practice Address - Phone:303-738-1100
Practice Address - Fax:303-738-1310
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COC-RXN.0001741-C-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty