MEDICARE: JULIE L MOORE PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5601005691	OTHER	MI	LICENSE

General Provider Information

NPI Number	:	1477888998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE L MOORE PA-C

Provider Business Mailing Address
First Line	:	1105 6TH ST
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-2349
Country	:	US
Telephone Number	:	231-947-0673
Fax Number	:

Provider Business Practice Location Address
First Line	:	4624 N SPIDER LAKE RD
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49696-8440
Country	:	US
Telephone Number	:	231-947-0673
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2009
Last Update Date	:	10/29/2012

Similar Medicare Providers

1942295274 — KARRI ELIZABETH VAUGHAN PA-C
Practice Location Address:

4624 N SPIDER LAKE RD
TRAVERSE CITY, MI
49696-8440

Practice Phone: 231-947-0673
Practice Fax:

1851637169 — MAUREEN E ASCIONE ACNP
Practice Location Address:

4624 N SPIDER LAKE RD
TRAVERSE CITY, MI
49696-8440

Practice Phone: 231-947-0673
Practice Fax: 801-740-2847

1326320474 — EULA ANN DOERING APRN-CNP
Practice Location Address:

2415 LYNCROSS ST
GROVE CITY, OH
43123-8440

Practice Phone: 614-716-8839
Practice Fax:

1164793287 — LISA SABIN MA,CCC,SLP
Practice Location Address:

1145 COLLINS AVE
ORANGE CITY, FL
32763-8440

Practice Phone: 386-956-0777
Practice Fax:

1750878013 — DR. ANDREW JACOB CREED MD
Practice Location Address:

4000 CAMBRIDGE ST
KANSAS CITY, KS
66160-8440

Practice Phone: 913-588-6970
Practice Fax: 913-588-6965

1922966381 — AUDREY VANG
Practice Location Address:

1363 DOUGLAS DR STE 104
TRAVERSE CITY, MI
49696-8980

Practice Phone: 231-668-4909
Practice Fax:

Directions to “ JULIE L MOORE PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.