Provider Demographics
NPI:1396750154
Name:SCHUETZ, JULIE A (CRNP)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:A
Last Name:SCHUETZ
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:LINDBLAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:PO BOX 62602
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-2602
Mailing Address - Country:US
Mailing Address - Phone:410-328-3929
Mailing Address - Fax:410-328-6896
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:410-328-3929
Practice Address - Fax:410-328-6896
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR089938363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS053-0029OtherCAREFIRST BC/BS REGIONAL
MD745400700Medicaid
MD820515-01, 520515-05OtherCAREFIRST BC/BS
MDS053-0029OtherCAREFIRST BC/BS REGIONAL
MD500008273Medicare PIN
MD820515-01, 520515-05OtherCAREFIRST BC/BS
MDP00240764Medicare PIN