Provider Demographics
NPI:1780744011
Name:MCMAHON, JULIE (RNP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:MCMAHON
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N ORANGE ST
Mailing Address - Street 2:STE. 205
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-2998
Mailing Address - Country:US
Mailing Address - Phone:406-327-1950
Mailing Address - Fax:406-327-3080
Practice Address - Street 1:900 N ORANGE ST
Practice Address - Street 2:STE. 205
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-2998
Practice Address - Country:US
Practice Address - Phone:406-327-1950
Practice Address - Fax:406-327-3080
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2017-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT100988363LA2200X
CA11446363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology