Provider Demographics
NPI:1285870543
Name:PETERSON, JULIE A (BA, COM)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:A
Last Name:PETERSON
Suffix:
Gender:F
Credentials:BA, COM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:796 S OWENS CT
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-3840
Mailing Address - Country:US
Mailing Address - Phone:303-725-8575
Mailing Address - Fax:
Practice Address - Street 1:796 S OWENS CT
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-3840
Practice Address - Country:US
Practice Address - Phone:303-725-8575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other