Provider Demographics
NPI:1083071278
Name:BLOUNT, JULIE ANN (RN, IBCLC)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANN
Last Name:BLOUNT
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 SE FRANK PHILLIPS BLVD.
Mailing Address - Street 2:JANE PHILLIPS MEDICAL CENTER
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-2464
Mailing Address - Country:US
Mailing Address - Phone:918-333-7200
Mailing Address - Fax:918-331-1120
Practice Address - Street 1:3500 SE FRANK PHILLIPS BLVD
Practice Address - Street 2:JANE PHILLIPS MEDICAL CENTER
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-2464
Practice Address - Country:US
Practice Address - Phone:918-333-7200
Practice Address - Fax:918-331-1120
Is Sole Proprietor?:No
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0062021163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant