Provider Demographics
NPI:1437614229
Name:LOUIS, JULIA (CNM)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:LOUIS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:LOUIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNM
Mailing Address - Street 1:2600 TAMARACK AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-5560
Mailing Address - Country:US
Mailing Address - Phone:860-646-1157
Mailing Address - Fax:
Practice Address - Street 1:2600 TAMARACK AVE STE 200
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-5560
Practice Address - Country:US
Practice Address - Phone:860-646-1157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT567367A00000X
NJ25ME00072001367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife