Provider Demographics
NPI:1366548133
Name:BRANN, JULIA ANN (NP, DMIN)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:ANN
Last Name:BRANN
Suffix:
Gender:F
Credentials:NP, DMIN
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:BRANN
Other - Last Name:WILMOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP, DMIN
Mailing Address - Street 1:1115 ELKTON DR STE 300
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-3597
Mailing Address - Country:US
Mailing Address - Phone:719-373-2075
Mailing Address - Fax:719-434-9811
Practice Address - Street 1:1115 ELKTON DR STE 300
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-3597
Practice Address - Country:US
Practice Address - Phone:719-373-2075
Practice Address - Fax:719-434-9811
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO85920363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health