Provider Demographics
NPI:1194703926
Name:DEVITA-BAILEY, JULIE ANN (DO)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:DEVITA-BAILEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 E ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-4007
Mailing Address - Country:US
Mailing Address - Phone:970-482-2791
Mailing Address - Fax:
Practice Address - Street 1:2551 W 84TH AVE
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3807
Practice Address - Country:US
Practice Address - Phone:303-561-5010
Practice Address - Fax:303-561-5050
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-03
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2OA8201207QG0300X
CO44663207QG0300X
CODR.0044663207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO026776OtherKAISER COMMERCIAL NUMBER
COP00389920OtherRAILROAD MEDICARE
CO53752244Medicaid
COI48573Medicare UPIN
CO026776OtherKAISER COMMERCIAL NUMBER