Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 110319 | IA |
NPI | 1043523491 |
---|---|
Provider Name | Julia A Hull |
First Address | Davenport, IA 52801-1014 |
Second Address | Davenport, IA 52804-1853 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2010 |
Last Update Date | 27/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1962496679 | (05) | IA |