Provider Demographics
NPI:1528238193
Name:WARD, JULIE J (CNM)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:J
Last Name:WARD
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 10TH AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-3606
Mailing Address - Country:US
Mailing Address - Phone:706-341-3311
Mailing Address - Fax:706-341-3096
Practice Address - Street 1:1900 10TH AVE STE 300
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-3606
Practice Address - Country:US
Practice Address - Phone:706-341-3311
Practice Address - Fax:706-341-3096
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2016-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000012963367A00000X
GARN148659367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA747370346AMedicaid
GA202I505389OtherMEDICARE PTAN
GARN148659OtherGA LICENSE