MEDICARE: JULIE ANNE QUICKERT ACNP-BC

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	363LA2100X	Acute Care Nurse Practitioner	111348	NE

General Provider Information

NPI Number	:	1760735831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE ANNE QUICKERT ACNP-BC

Provider Business Mailing Address
First Line	:	4848 THOMPSON PKWY
Second Line	:	SUITE 300
City	:	JOHNSTOWN
State	:	CO
Zip	:	80534-6433
Country	:	US
Telephone Number	:	970-800-4145
Fax Number	:

Provider Business Practice Location Address
First Line	:	4848 THOMPSON PKWY
Second Line	:	SUITE 300
City	:	JOHNSTOWN
State	:	CO
Zip	:	80534-6433
Country	:	US
Telephone Number	:	970-800-4145
Fax Number	:

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

Provider Enumeration Date	:	10/25/2012
Last Update Date	:	12/18/2018

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