Provider Demographics
NPI:1801187778
Name:HARTL, JULIE ANNA (MSN, NP-C)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANNA
Last Name:HARTL
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Gender:F
Credentials:MSN, NP-C
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Mailing Address - Street 1:815 BUSINESS PARK DR
Mailing Address - Street 2:STE A
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-8683
Mailing Address - Country:US
Mailing Address - Phone:231-421-6921
Mailing Address - Fax:231-421-7852
Practice Address - Street 1:4020 COPPER VW STE 104
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-7041
Practice Address - Country:US
Practice Address - Phone:231-421-6921
Practice Address - Fax:231-421-7852
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2021-06-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704230268363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner