Provider Demographics
NPI:1104458926
Name:JULIE UNRUH, INC
Entity type:Organization
Organization Name:JULIE UNRUH, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:UNRUH
Authorized Official - Suffix:
Authorized Official - Credentials:CRNFA
Authorized Official - Phone:719-650-1519
Mailing Address - Street 1:PO BOX 3525
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-3525
Mailing Address - Country:US
Mailing Address - Phone:719-650-1519
Mailing Address - Fax:
Practice Address - Street 1:16389 GAUCHO GULCH GRV
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-7811
Practice Address - Country:US
Practice Address - Phone:719-650-1519
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-10
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty