Provider Demographics
NPI:1639318355
Name:HAVENER, JULIE ANNE (CPM)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANNE
Last Name:HAVENER
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 414
Mailing Address - Street 2:
Mailing Address - City:NORTHEAST HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04662-0414
Mailing Address - Country:US
Mailing Address - Phone:207-276-4109
Mailing Address - Fax:
Practice Address - Street 1:27 SOUTH SHORE RD.
Practice Address - Street 2:
Practice Address - City:NORTHEAST HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04662-0414
Practice Address - Country:US
Practice Address - Phone:207-276-4109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife