Healthcare Provider Details

I. General information

NPI: 1720554488
Provider Name (Legal Business Name): JULIA MARIE MUONIO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIA MARIE TIKKA NP

II. Dates (important events)

Enumeration Date: 10/22/2018
Last Update Date: 02/09/2024
Certification Date: 02/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 HERITAGE WAY STE 202
KALISPELL MT
59901
US

IV. Provider business mailing address

160 HERITAGE WAY STE 202
KALISPELL MT
59901-3127
US

V. Phone/Fax

Practice location:
  • Phone: 406-752-8433
  • Fax: 406-752-8433
Mailing address:
  • Phone: 406-752-8433
  • Fax: 406-752-8433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNUR-APRN-LIC-131997
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: