Provider Demographics
NPI:1508135443
Name:DUNHAM, JULIA KATHERINE (MSN, RN, BC-ANP)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:KATHERINE
Last Name:DUNHAM
Suffix:
Gender:F
Credentials:MSN, RN, BC-ANP
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Mailing Address - Street 1:216 S KINGSHIGHWAY BLVD
Mailing Address - Street 2:MAILSTOP: 90-00-049
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1026
Mailing Address - Country:US
Mailing Address - Phone:314-454-7428
Mailing Address - Fax:314-454-5268
Practice Address - Street 1:216 S KINGSHIGHWAY BLVD
Practice Address - Street 2:MAILSTOP: 90-00-049
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1026
Practice Address - Country:US
Practice Address - Phone:314-454-7428
Practice Address - Fax:314-454-5268
Is Sole Proprietor?:No
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO120278363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health