# JULIE A BLEYENBERG

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1962443986
- **Gender:** F
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 13421 | NH | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | PENDING | OH | — |
| 207VC0200X | Critical Care Medicine (Obstetrics & Gynecology) Physician | 13421 | NH | — |
| 207VC0200X | Critical Care Medicine (Obstetrics & Gynecology) Physician | PENDING | OH | — |
| 207VG0400X | Gynecology Physician | PENDING | OH | — |

## Other

- **Enumeration date:** 06/09/2006
- **Last updated:** 03/19/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2669901 | — | OH |
| 05 | — | 3071612 | — | NH |
| 01 | — | 34-008813 | LICENSE 7-31-09 EXP | OH |