Provider Demographics
NPI:1770030561
Name:MARTIN, JULIE MARIE (APRN, FNP)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:MARIE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 N TERRACE ST
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53548-2906
Mailing Address - Country:US
Mailing Address - Phone:608-756-7277
Mailing Address - Fax:608-373-3115
Practice Address - Street 1:510 N TERRACE ST
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-2906
Practice Address - Country:US
Practice Address - Phone:608-756-7277
Practice Address - Fax:608-373-3115
Is Sole Proprietor?:No
Enumeration Date:2016-09-08
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI160076-30163W00000X
WI7212-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse