Healthcare Provider Details

I. General information

NPI: 1588699334
Provider Name (Legal Business Name): JULIE A CHARLTON CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 JOHNSON FY RD NE STE 210
ATLANTA GA
30342-1601
US

IV. Provider business mailing address

116 WOODHAVEN LN
BALL GROUND GA
30107-3106
US

V. Phone/Fax

Practice location:
  • Phone: 404-847-1592
  • Fax: 678-805-2248
Mailing address:
  • Phone: 972-215-9440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN099786
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: