Provider Demographics
NPI:1427101856
Name:KELSO, JULIE RENEE (MD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:RENEE
Last Name:KELSO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:KELSO HEGGEM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:123 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-4227
Mailing Address - Country:US
Mailing Address - Phone:406-247-3350
Mailing Address - Fax:406-247-3389
Practice Address - Street 1:123 S 27TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-4227
Practice Address - Country:US
Practice Address - Phone:406-247-3350
Practice Address - Fax:406-247-3389
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT114892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry