Provider Demographics
NPI:1033150370
Name:THOMPON, JULIANNA J (CNM)
Entity Type:Individual
Prefix:
First Name:JULIANNA
Middle Name:J
Last Name:THOMPON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15 OAK GLEN DR
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1232
Mailing Address - Country:US
Mailing Address - Phone:610-251-2593
Mailing Address - Fax:610-251-2593
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:MOB EAST SUITE 353
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:610-251-2593
Practice Address - Fax:610-251-2593
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMW-008614-L367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife