Provider Demographics
NPI:1013497585
Name:BUMPUS, JULIE ANNE X (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANNE
Last Name:BUMPUS
Suffix:X
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4848 GREGORY RD STE A
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:MI
Mailing Address - Zip Code:48130-9628
Mailing Address - Country:US
Mailing Address - Phone:734-726-5421
Mailing Address - Fax:949-543-2300
Practice Address - Street 1:7444 ANN ARBOR STREET
Practice Address - Street 2:SUITE D
Practice Address - City:DEXTER
Practice Address - State:MI
Practice Address - Zip Code:48130-1419
Practice Address - Country:US
Practice Address - Phone:734-730-8445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-15
Last Update Date:2023-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704237867363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health