Provider Demographics
NPI:1588699334
Name:CHARLTON, JULIE A (CNM)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:CHARLTON
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 1:116 WOODHAVEN LN
Mailing Address - Street 2:
Mailing Address - City:BALL GROUND
Mailing Address - State:GA
Mailing Address - Zip Code:30107-3106
Mailing Address - Country:US
Mailing Address - Phone:972-215-9440
Mailing Address - Fax:
Practice Address - Street 1:960 JOHNSON FY RD NE STE 210
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1601
Practice Address - Country:US
Practice Address - Phone:404-847-1592
Practice Address - Fax:678-805-2248
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN099786367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty