Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 95007258 | CA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 95007258 | CA |
NPI | 1073031993 |
---|---|
Provider Name | Julia Thrasher |
First Address | San Diego, CA 92193-2410 |
Second Address | San Diego, CA 92103-9000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2017 |
Last Update Date | 25/04/2018 |