Provider Demographics
NPI:1538154661
Name:PRUTSMAN, JULIE LOUISE (AUD, CCC-A)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:LOUISE
Last Name:PRUTSMAN
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:LOUISE
Other - Last Name:SWENSSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AUD
Mailing Address - Street 1:9330 S. UNIVERSITY BLVD.
Mailing Address - Street 2:SUITE 240
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80126
Mailing Address - Country:US
Mailing Address - Phone:720-344-7600
Mailing Address - Fax:303-346-5036
Practice Address - Street 1:9330 S. UNIVERSITY BLVD.
Practice Address - Street 2:SUITE 240
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80126
Practice Address - Country:US
Practice Address - Phone:720-344-7600
Practice Address - Fax:303-346-5036
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV161231H00000X
NV272237600000X
CO124237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV38694OtherGROUP PIN
NV38696Medicare UPIN
NV38694OtherGROUP PIN
NVV38694Medicare UPIN
NVV38696Medicare UPIN