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General NPI Number Information
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NPI Number | 1639735616
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Entity Type | Individual
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Provider Name | JULIE RENEE SHIELDS NP
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Gender | Female
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Dates
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Enumeration Date | 05/14/2019
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Last Update Date | 03/09/2021
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Provider Practice Location Address
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Address Line | 350 HERITAGE WAY STE 2300
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City | KALISPELL
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State | MT
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Zip | 59901-3167
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Country | US
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Telephone | 406-752-8456
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Fax |
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Provider Business Mailing Address
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Address Line | 487 OBRYAN LN
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City | KALISPELL
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State | MT
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Zip | 59901-8805
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Country | US
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Telephone | 406-471-9025
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | NUR-APRN-LIC-131696
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License Number State | MT
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