Provider Demographics
NPI:1396077764
Name:SIEBEN, JULIE MICHELLE (DC)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:MICHELLE
Last Name:SIEBEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12200 TECH RD STE 104
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7871
Mailing Address - Country:US
Mailing Address - Phone:301-622-9000
Mailing Address - Fax:
Practice Address - Street 1:632 MAIN ST
Practice Address - Street 2:
Practice Address - City:DENNIS
Practice Address - State:MA
Practice Address - Zip Code:02638
Practice Address - Country:US
Practice Address - Phone:508-385-9999
Practice Address - Fax:508-385-4590
Is Sole Proprietor?:No
Enumeration Date:2010-02-09
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3337111N00000X
MARN2311826363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No111N00000XChiropractic ProvidersChiropractor