Provider Demographics
NPI:1831843234
Name:GRITZ, JULIE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:GRITZ
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13395 VOYAGER PKWY STE 130 #1103
Mailing Address - Street 2:STE 30 #1103
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-3669
Mailing Address - Country:US
Mailing Address - Phone:719-396-2970
Mailing Address - Fax:719-428-1211
Practice Address - Street 1:1322 N ACADEMY BLVD STE 114C
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-3327
Practice Address - Country:US
Practice Address - Phone:719-428-1210
Practice Address - Fax:719-428-1211
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-05
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0101823363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO90022046Medicaid