Provider Demographics
NPI:1982275681
Name:SLYZELIA, JULIE ALLISON (LM, CPM)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ALLISON
Last Name:SLYZELIA
Suffix:
Gender:F
Credentials:LM, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W7550 SPRING RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54942-8628
Mailing Address - Country:US
Mailing Address - Phone:920-642-3221
Mailing Address - Fax:
Practice Address - Street 1:W7550 SPRING RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:WI
Practice Address - Zip Code:54942-8628
Practice Address - Country:US
Practice Address - Phone:920-642-3221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-05
Last Update Date:2021-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI86-49176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife