Provider Demographics
NPI:1013146109
Name:KNUTSON, JULIE ANNA (RN, CNM)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNA
Last Name:KNUTSON
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANNA
Other - Last Name:LAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CNM
Mailing Address - Street 1:829 GRANT PL
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80302-7414
Mailing Address - Country:US
Mailing Address - Phone:401-338-0434
Mailing Address - Fax:
Practice Address - Street 1:101 DUDLEY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-2401
Practice Address - Country:US
Practice Address - Phone:401-274-1122
Practice Address - Fax:401-459-0100
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1618525163W00000X
DC1015636163W00000X
COAPN.0992140-NP363LW0102X
COAPN.0991400-CNM367A00000X
RICNM00182367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health