Provider Demographics
NPI:1629011705
Name:HIGHMARK, JULIE ANNE (NP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:HIGHMARK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E 1ST ST
Mailing Address - Street 2:STE LL
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-2297
Mailing Address - Country:US
Mailing Address - Phone:218-722-5629
Mailing Address - Fax:
Practice Address - Street 1:1000 E 1ST ST
Practice Address - Street 2:STE LL
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-2297
Practice Address - Country:US
Practice Address - Phone:218-722-5629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR0925185363LX0001X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0703438OtherMEDICA
MN085K4HIOtherBCBSM
MNHP22943OtherHEALTH PARTNERS
MN117025OtherUCARE
WI43945000Medicaid
MNA014OtherTRIWEST
MN01012374OtherPREFERRED ONE
MN627216900Medicaid