Provider Demographics
NPI:1255749719
Name:BAUER, JULIE ANN (PA-C)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANN
Last Name:BAUER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8841 E BELL RD STE 201
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-1984
Mailing Address - Country:US
Mailing Address - Phone:480-398-1550
Mailing Address - Fax:
Practice Address - Street 1:8841 E BELL RD STE 201
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-1984
Practice Address - Country:US
Practice Address - Phone:480-398-1550
Practice Address - Fax:480-398-1551
Is Sole Proprietor?:No
Enumeration Date:2014-07-29
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5712363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant