Provider Demographics
NPI:1164649232
Name:POEPOE, JULIE ANNE (FNP)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANNE
Last Name:POEPOE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:ANNE
Other - Last Name:TEER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1 LMU DR # MS -8455
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-2623
Mailing Address - Country:US
Mailing Address - Phone:310-338-2881
Mailing Address - Fax:
Practice Address - Street 1:16007 CRENSHAW BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90506-0003
Practice Address - Country:US
Practice Address - Phone:310-660-3643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA530714363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily