Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 568004 | TX |
NPI | 1245294834 |
---|---|
Provider Name | Ms. Julie Marie Seale |
First Address | Fort Worth, TX 76104-2158 |
Second Address | Fort Worth, TX 76104-2158 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 21/07/2007 |