Provider Demographics
NPI:1780922047
Name:LIGDAY, JULIE SUSANNE (NP)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:SUSANNE
Last Name:LIGDAY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1095 CREEKSIDE XING
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-9623
Mailing Address - Country:US
Mailing Address - Phone:651-430-1784
Mailing Address - Fax:
Practice Address - Street 1:1690 UNIVERSITY AVE W STE 115
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-3118
Practice Address - Country:US
Practice Address - Phone:651-232-2002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR156148-3363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner