Provider Demographics
NPI:1730151978
Name:OLECHNOWICZ, JULIE ANN (MSN NP C)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:OLECHNOWICZ
Suffix:
Gender:F
Credentials:MSN NP C
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:FAGERLIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN NP C
Mailing Address - Street 1:932 N MITCHELL ST
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-1285
Mailing Address - Country:US
Mailing Address - Phone:313-497-1782
Mailing Address - Fax:833-523-5032
Practice Address - Street 1:2366 OAK VALLEY DR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-8944
Practice Address - Country:US
Practice Address - Phone:877-227-8823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJF229369363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4949241Medicaid
MI4949232Medicaid
MI4949232Medicaid
MI4949241Medicaid
MI4949241Medicaid
MI4949232Medicaid