Provider Demographics
NPI:1386954816
Name:HOUDEK, JULIA R (NP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:R
Last Name:HOUDEK
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:OBSTETRICS AND GYNECOLOGY
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-805-6600
Mailing Address - Fax:414-805-6622
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:OBSTETRICS AND GYNECOLOGY
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-805-6600
Practice Address - Fax:414-805-6622
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2016-01-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI155895163W00000X
WI4233363LX0001X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No163W00000XNursing Service ProvidersRegistered Nurse
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1386954816Medicaid