Healthcare Provider Details
I. General information
NPI: 1023855996
Provider Name (Legal Business Name): JULIE TU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/09/2024
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 ALPINE AVE
BOULDER CO
80304-3406
US
IV. Provider business mailing address
1086 10TH ST
BOULDER CO
80302-7261
US
V. Phone/Fax
- Phone: 260-693-7708
- Fax:
- Phone: 260-693-7708
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: