Provider Demographics
NPI:1215203328
Name:ROBERTS, JULIE NOEL (RN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:NOEL
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:NOEL
Other - Last Name:MIDTHUNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2001 N CENTER ST
Mailing Address - Street 2:
Mailing Address - City:BONHAM
Mailing Address - State:TX
Mailing Address - Zip Code:75418-2625
Mailing Address - Country:US
Mailing Address - Phone:903-583-3606
Mailing Address - Fax:903-640-7606
Practice Address - Street 1:2001 N CENTER ST
Practice Address - Street 2:
Practice Address - City:BONHAM
Practice Address - State:TX
Practice Address - Zip Code:75418-2625
Practice Address - Country:US
Practice Address - Phone:903-583-3606
Practice Address - Fax:903-640-7606
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX680296163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse