Provider Demographics
NPI:1568750818
Name:THOMPSON, JULIE MARIE (RN)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24365 W CEDAR LAKE DR
Mailing Address - Street 2:
Mailing Address - City:NEW PRAGUE
Mailing Address - State:MN
Mailing Address - Zip Code:56071-7564
Mailing Address - Country:US
Mailing Address - Phone:952-212-4709
Mailing Address - Fax:
Practice Address - Street 1:24365 W CEDAR LAKE DR
Practice Address - Street 2:
Practice Address - City:NEW PRAGUE
Practice Address - State:MN
Practice Address - Zip Code:56071-7564
Practice Address - Country:US
Practice Address - Phone:952-212-4709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR124293-5163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health