Provider Demographics
NPI:1942553102
Name:MACKIE, JULIE L (CD(DONA))
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:L
Last Name:MACKIE
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 E 104TH AVE
Mailing Address - Street 2:528
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80233-6174
Mailing Address - Country:US
Mailing Address - Phone:773-704-1438
Mailing Address - Fax:
Practice Address - Street 1:2525 E 104TH AVE
Practice Address - Street 2:528
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80233-6174
Practice Address - Country:US
Practice Address - Phone:773-704-1438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula