Provider Demographics
NPI:1275519670
Name:HALL, JULIE KRELL (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:KRELL
Last Name:HALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:MICHELLE
Other - Last Name:KRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7337 E COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-8430
Mailing Address - Country:US
Mailing Address - Phone:303-579-5922
Mailing Address - Fax:877-541-9457
Practice Address - Street 1:7337 E COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80504-8430
Practice Address - Country:US
Practice Address - Phone:303-579-5922
Practice Address - Fax:877-541-9457
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO41565207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP00043257OtherRAILROAD MEDICARE PIN
CO25689088Medicaid
CO501738Medicare PIN
COH83451Medicare UPIN
CO25689088Medicaid