Provider Demographics
NPI:1427487297
Name:PIGNOTTI, JULIE ANNE (PA-C)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:PIGNOTTI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4328 89TH ST
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-2415
Mailing Address - Country:US
Mailing Address - Phone:262-705-8894
Mailing Address - Fax:
Practice Address - Street 1:2707 15TH PL
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53140-4947
Practice Address - Country:US
Practice Address - Phone:262-551-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-02
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3214363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant