Provider Demographics
NPI:1700944030
Name:SHERRICK, JULIA BRADSHAW (CNM)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:BRADSHAW
Last Name:SHERRICK
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:LYNN
Other - Last Name:BRADSHAW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:195 COMMONS LOOP
Mailing Address - Street 2:SUITE D
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-1912
Mailing Address - Country:US
Mailing Address - Phone:406-752-8180
Mailing Address - Fax:406-752-1056
Practice Address - Street 1:195 COMMONS LOOP
Practice Address - Street 2:SUITE D
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-1912
Practice Address - Country:US
Practice Address - Phone:406-752-8180
Practice Address - Fax:406-752-1056
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT21120367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0434129Medicaid
MT0438230Medicaid
MT36120OtherBCBS
MT36120OtherBCBS