Provider Demographics
NPI:1164474888
Name:GARSIDE, JULIE L (NP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:L
Last Name:GARSIDE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 SOUTH PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-5654
Mailing Address - Country:US
Mailing Address - Phone:303-744-1065
Mailing Address - Fax:303-733-1699
Practice Address - Street 1:1000 SOUTH PARK DRIVE
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-5654
Practice Address - Country:US
Practice Address - Phone:303-744-1065
Practice Address - Fax:303-733-1699
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO111945363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP90701Medicare UPIN
P90701Medicare UPIN