Healthcare Provider Details

I. General information

NPI: 1104606730
Provider Name (Legal Business Name): JULIE ANN CURTIS CHW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2023
Last Update Date: 10/02/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56720 CALUMET AVE
CALUMET MI
49913-1967
US

IV. Provider business mailing address

56720 CALUMET AVE
CALUMET MI
49913-1967
US

V. Phone/Fax

Practice location:
  • Phone: 906-483-1177
  • Fax: 906-481-3094
Mailing address:
  • Phone: 906-483-1177
  • Fax: 906-481-3094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: