Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 01-04573 | KS |
NPI | 1154539914 |
---|---|
Provider Name | Dr. Julie Ann Nitschke |
First Address | Whitehouse, TX 75791-3115 |
Second Address | Whitehouse, TX 75791-3115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 19/09/2020 |