Provider Demographics
NPI:1821403221
Name:BAATUMA, JULIE GRACE (APRN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:GRACE
Last Name:BAATUMA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:SSEKUUBWA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-3245
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:200 EAST CHESTNUT STREET
Practice Address - Street 2:N-11
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202
Practice Address - Country:US
Practice Address - Phone:502-629-5552
Practice Address - Fax:502-629-3132
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008722363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100301270Medicaid
IN300013926Medicaid