Provider Demographics
NPI:1386928133
Name:BALLMANN, JULIE M (PHARMD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:BALLMANN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 HIGHWAY 50 E
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:MO
Mailing Address - Zip Code:63084-2248
Mailing Address - Country:US
Mailing Address - Phone:636-583-7896
Mailing Address - Fax:636-583-5149
Practice Address - Street 1:807 HIGHWAY 50 E
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MO
Practice Address - Zip Code:63084-2248
Practice Address - Country:US
Practice Address - Phone:636-583-7896
Practice Address - Fax:636-583-5149
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008029228183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist