Provider Demographics
NPI:1457247736
Name:FERWERDA, JULIE ANNE
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:FERWERDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17806 E TENNESSEE PL
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-3332
Mailing Address - Country:US
Mailing Address - Phone:208-220-3175
Mailing Address - Fax:
Practice Address - Street 1:6800 SPURWING LOOP APT 302
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-7755
Practice Address - Country:US
Practice Address - Phone:208-220-3175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-14
Last Update Date:2025-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID51101163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse