Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 00028980 | OH |
N | 363LW0102X | Nurse Practitioner - Women's Health | 0028980 | OH |
NPI | 1013464742 |
---|---|
Provider Name | Julie Marie Thompson |
First Address | Lancaster, OH 43130-7642 |
Second Address | Eglin Afb, FL 32542-1302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2016 |
Last Update Date | 01/09/2021 |