Provider Demographics
NPI:1417471079
Name:IGNACE, JULIE MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE
Last Name:IGNACE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2217
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86003-2217
Mailing Address - Country:US
Mailing Address - Phone:928-220-5063
Mailing Address - Fax:
Practice Address - Street 1:824 S SAN FRANCISCO STREET
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86011-3260
Practice Address - Country:US
Practice Address - Phone:928-523-2131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2021-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP10375363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner