Provider Demographics
NPI:1871861005
Name:SEMINARA, JULIE ANN (PA)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:SEMINARA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 S ATLANTIC ST
Mailing Address - Street 2:
Mailing Address - City:DILLON
Mailing Address - State:MT
Mailing Address - Zip Code:59725-2715
Mailing Address - Country:US
Mailing Address - Phone:406-683-4400
Mailing Address - Fax:406-683-4408
Practice Address - Street 1:120 S ATLANTIC ST
Practice Address - Street 2:
Practice Address - City:DILLON
Practice Address - State:MT
Practice Address - Zip Code:59725-2715
Practice Address - Country:US
Practice Address - Phone:406-683-4400
Practice Address - Fax:406-683-4408
Is Sole Proprietor?:No
Enumeration Date:2011-12-02
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTMT-MED-PAC-LIC-62752363AM0700X
TX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX290117501Medicaid
TXPO1004875OtherMEDICARE RAILROAD
TXTXB143311Medicare Oscar/Certification