Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 509852 | TX |
NPI | 1417938937 |
---|---|
Provider Name | Julie Gay Loudamy |
First Address | Belfast, ME 04915-4084 |
Second Address | Waco, TX 76712-7919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2005 |
Last Update Date | 06/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P71379 | (02) | TX |