Provider Demographics
NPI:1225085491
Name:TANOUS, JULIE E (NP-C)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:E
Last Name:TANOUS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:E
Other - Last Name:SCHMIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3100 N 11TH ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58503-1210
Mailing Address - Country:US
Mailing Address - Phone:701-712-0066
Mailing Address - Fax:701-712-0077
Practice Address - Street 1:3100 N 11TH ST STE 1
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-1210
Practice Address - Country:US
Practice Address - Phone:701-712-0066
Practice Address - Fax:701-712-0077
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR26921363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND19722Medicaid
ND500026115OtherRR MEDICARE
NDP64430Medicare UPIN
ND19722Medicaid