Provider Demographics
NPI:1255681110
Name:BACHE, JULIE ANN (CNM)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:BACHE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:LORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:PO BOX 12622
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4017
Mailing Address - Country:US
Mailing Address - Phone:410-573-1094
Mailing Address - Fax:410-573-1097
Practice Address - Street 1:2003 MEDICAL PKWY
Practice Address - Street 2:SUITE G50
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7992
Practice Address - Country:US
Practice Address - Phone:410-573-1094
Practice Address - Fax:410-573-1097
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2015-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD9071875OtherAETNA PPO
MD2524424OtherCIGNA
MD9071875OtherAETNA HMO
MD057765100Medicaid
MD6832-0016OtherCAREFIRST
MD057765100Medicaid
MD249881Y5ZMedicare PIN