Healthcare Provider Details

I. General information

NPI: 1306121660
Provider Name (Legal Business Name): JULIE SOKOLOW NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2011
Last Update Date: 01/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 S DRAKE RD STE B
KALAMAZOO MI
49009-1171
US

IV. Provider business mailing address

317 S DRAKE RD STE B
KALAMAZOO MI
49009-1171
US

V. Phone/Fax

Practice location:
  • Phone: 269-324-5100
  • Fax: 269-353-6318
Mailing address:
  • Phone: 269-324-5100
  • Fax: 269-353-6318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number4704152682
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: