Provider Demographics
NPI:1649921842
Name:JULKA, MANMEESH KAUR
Entity type:Individual
Prefix:
First Name:MANMEESH
Middle Name:KAUR
Last Name:JULKA
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 1:4752 BRENTON DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-6064
Mailing Address - Country:US
Mailing Address - Phone:262-844-6668
Mailing Address - Fax:
Practice Address - Street 1:105 W TROUTMAN PKWY
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3038
Practice Address - Country:US
Practice Address - Phone:970-223-0840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO23792183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist