Provider Demographics
NPI:1891510947
Name:ALLISON, JULIE (NBC-HWC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:ALLISON
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:MISS
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:KRUTKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:755 GREEN BAY DR APT 3
Mailing Address - Street 2:
Mailing Address - City:MAYVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53050-1755
Mailing Address - Country:US
Mailing Address - Phone:951-821-1233
Mailing Address - Fax:
Practice Address - Street 1:755 GREEN BAY DR APT 3
Practice Address - Street 2:
Practice Address - City:MAYVILLE
Practice Address - State:WI
Practice Address - Zip Code:53050-1755
Practice Address - Country:US
Practice Address - Phone:951-821-1233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A-3901724171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach