Healthcare Provider Details

I. General information

NPI: 1710985510
Provider Name (Legal Business Name): JULIE K BRUEGGEMEIER CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 HARROUN RD STE 112
SYLVANIA OH
43560-2146
US

IV. Provider business mailing address

5300 HARROUN RD STE 112
SYLVANIA OH
43560-2146
US

V. Phone/Fax

Practice location:
  • Phone: 419-824-5608
  • Fax: 419-824-1772
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN.CNM.07135
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: