Provider Demographics
NPI:1346491172
Name:MAHER, JULIE J (MMS, PA-C)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:J
Last Name:MAHER
Suffix:
Gender:F
Credentials:MMS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7335 S PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-4571
Mailing Address - Country:US
Mailing Address - Phone:303-979-7200
Mailing Address - Fax:303-933-5265
Practice Address - Street 1:7335 S PIERCE ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-4571
Practice Address - Country:US
Practice Address - Phone:303-979-7200
Practice Address - Fax:303-933-5265
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0002667363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO023628OtherKAISER COMMERCIAL NUMBER
CO76620557Medicaid
CO76620557Medicaid