Provider Demographics
NPI:1841335452
Name:BALTZ, JULIE H (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:H
Last Name:BALTZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 ALTAIR PKWY STE 3100
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-7653
Mailing Address - Country:US
Mailing Address - Phone:614-360-9995
Mailing Address - Fax:614-745-0165
Practice Address - Street 1:400 ALTAIR PKWY STE 3100
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-7653
Practice Address - Country:US
Practice Address - Phone:614-360-9995
Practice Address - Fax:614-745-0165
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9100858363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPA.0007347OtherLICENSE NUMBER
TN5756OtherLICENSE NUMBER
FLPA9100858OtherLICENSE NUMBER
OH50.008128RXOtherLICENSE NUMBER
LA338552OtherLICENSE NUMBER