Provider Demographics
NPI:1821187485
Name:ERNEST, JULIE K (CCC-SLP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:K
Last Name:ERNEST
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:ERNEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,CCC/SLP
Mailing Address - Street 1:14130 23RD AVE N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447
Mailing Address - Country:US
Mailing Address - Phone:763-383-7666
Mailing Address - Fax:763-383-6013
Practice Address - Street 1:14425 8TH AVE N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-4456
Practice Address - Country:US
Practice Address - Phone:651-260-9915
Practice Address - Fax:763-383-6013
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6402235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN179304700Medicaid
MN34776OtherHEALTH PARTNERS
MN54M23EROtherBLUE CROSS BLUE SHEILD
MN4600382OtherCBSA
MN205451043548OtherPREFERRED ONE
MN4600382OtherMEDICA
MN181363OtherU CARE