Provider Demographics
NPI:1952444317
Name:BORGEN, JULIE EDITH (HIS)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:EDITH
Last Name:BORGEN
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5201 EDEN AVENUE SUITE 50
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55436-2316
Mailing Address - Country:US
Mailing Address - Phone:952-929-2060
Mailing Address - Fax:952-929-2067
Practice Address - Street 1:5201 EDEN AVENUE SUITE 50
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55436-2316
Practice Address - Country:US
Practice Address - Phone:952-929-2060
Practice Address - Fax:952-929-2067
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2371237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2371OtherHID LICENSE
MN064913900Medicaid