Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 5011729-4405 | UT |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 5011729-8900 | UT |
NPI | 1073160362 |
---|---|
Provider Name | Julia Christine Thomas |
First Address | Riverton, UT 84065-4785 |
Second Address | Slc, UT 84113-1103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2019 |
Last Update Date | 21/08/2019 |