Provider Demographics
NPI:1154584068
Name:VENCI, JULIE A
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:VENCI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4699 W 36TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80212-1572
Mailing Address - Country:US
Mailing Address - Phone:708-712-1130
Mailing Address - Fax:
Practice Address - Street 1:301 W 6TH AVE
Practice Address - Street 2:MAIL CODE 3250
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-5182
Practice Address - Country:US
Practice Address - Phone:303-602-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-10
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125051018207R00000X, 208000000X
CO49046207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics