Healthcare Provider Details

I. General information

NPI: 1366045650
Provider Name (Legal Business Name): JULIE ASHCRAFT PHMNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JULIE CRUZ

II. Dates (important events)

Enumeration Date: 11/18/2020
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2993 BROADMOOR VALLEY RD STE 103
COLORADO SPRINGS CO
80906-4471
US

IV. Provider business mailing address

2993 BROADMOOR VALLEY RD STE 103
COLORADO SPRINGS CO
80906-4471
US

V. Phone/Fax

Practice location:
  • Phone: 719-301-7731
  • Fax:
Mailing address:
  • Phone: 719-301-7731
  • Fax: 719-434-9730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.0996137-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: