Provider Demographics
NPI:1588209571
Name:MACKENDRICK, JULIA (RN CPNP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:MACKENDRICK
Suffix:
Gender:F
Credentials:RN CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16830 NORTHGATE DR UNIT 150
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-5778
Mailing Address - Country:US
Mailing Address - Phone:303-805-7879
Mailing Address - Fax:
Practice Address - Street 1:16830 NORTHGATE DR UNIT 150
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-5778
Practice Address - Country:US
Practice Address - Phone:303-805-7879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-13
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ234681363LP0200X
COC-APN.0100260-C-NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics