Provider Demographics
NPI:1053424150
Name:COENEN, JULIA F (NP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:F
Last Name:COENEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:321 E HARRIS ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48813-1629
Mailing Address - Country:US
Mailing Address - Phone:517-543-1050
Mailing Address - Fax:517-541-5870
Practice Address - Street 1:111 LANSING ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLOTTE
Practice Address - State:MI
Practice Address - Zip Code:48813-2400
Practice Address - Country:US
Practice Address - Phone:517-543-5110
Practice Address - Fax:517-543-9776
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704199741363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI481762711Medicaid
MI481762711Medicaid