Provider Demographics
NPI:1710985510
Name:BRUEGGEMEIER, JULIE K (CNM)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:K
Last Name:BRUEGGEMEIER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 HARROUN RD STE 112
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2146
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5300 HARROUN RD STE 112
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2146
Practice Address - Country:US
Practice Address - Phone:419-824-5608
Practice Address - Fax:419-824-1772
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNM.07135367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH344428256OtherBEECH STREET
OH000000253968OtherANTHEM
OH05225OtherPARAMOUNT
MI4473016Medicaid
OH2372267Medicaid
OH000000253968OtherANTHEM
OH05225OtherPARAMOUNT
OH344428256OtherBEECH STREET