Provider Demographics
NPI:1962799668
Name:COLICCHIO, JULIE PISARKIEWICZ (ANP)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:PISARKIEWICZ
Last Name:COLICCHIO
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Gender:F
Credentials:ANP
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Mailing Address - Street 1:660 S EUCLID AVE
Mailing Address - Street 2:MSC 8109-05-06
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1010
Mailing Address - Country:US
Mailing Address - Phone:314-362-2280
Mailing Address - Fax:888-352-8360
Practice Address - Street 1:1 BARNES JEWISH HOSPITAL PLZ
Practice Address - Street 2:DIV SURG TRANSPLANT
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1003
Practice Address - Country:US
Practice Address - Phone:314-747-9889
Practice Address - Fax:314-361-4197
Is Sole Proprietor?:No
Enumeration Date:2011-07-01
Last Update Date:2021-11-15
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Provider Licenses
StateLicense IDTaxonomies
MO2011016059363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO425655008Medicaid