Julie Bolha, PPCNP-BC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

3752033 Issued in WI

Practice address

611 Veterans Ave
West Bend, WI 53090-2545

Phone

(262) 353-4460

Fax

(262) 353-4461

NPI assigned

Oct 13, 2009

Last updated

Jan 13, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jbolha36051@direct.chw.org

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1386979193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 W WISCONSIN AVE # MS 958",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532264874",
            "telephone_number": "414-266-7615",
            "fax_number": "414-266-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 VETERANS AVE",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530902545",
            "telephone_number": "262-353-4460",
            "fax_number": "262-353-4461"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7861 State Road 60",
            "address_purpose": "LOCATION",
            "city": "Cedarburg",
            "state": "WI",
            "postal_code": "530129305",
            "country_code": "US",
            "telephone_number": "262-546-1050",
            "fax_number": "262-546-1051",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7950 N Port Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Fox Point",
            "state": "WI",
            "postal_code": "532173131",
            "country_code": "US",
            "telephone_number": "414-228-0099",
            "fax_number": "414-353-4461",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1655 W Mequon Rd",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530923254",
            "country_code": "US",
            "telephone_number": "262-240-9744",
            "fax_number": "262-240-9745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLHA",
        "first_name": "JULIE",
        "credential": "PPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-13",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WI",
            "license": "3752033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386979193",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacy L Boden, NP
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• Elizabeth Marie Bohn
• Bordeaux SLP & Consulting, LLC (Mke SLP)
• Andrew Russell Bordeaux, M.S., CCC-SLP
• Allyssa L Bosse, LPC
• Lisa S Bosshard, MD
• Irene Isabel Bozich, M.D.

• Pediatric Nurse Practitioner in West Bend, WI
• Providers in West Bend, WI by specialty
• Pediatric Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.