Provider Demographics
NPI:1710384193
Name:LONGMIRE, JULIE ANNE (FNP-C)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:LONGMIRE
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 1:9299 E DESERT VW
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-6218
Mailing Address - Country:US
Mailing Address - Phone:480-231-8146
Mailing Address - Fax:480-941-8220
Practice Address - Street 1:10565 N 114TH ST
Practice Address - Street 2:STE. #103
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-4942
Practice Address - Country:US
Practice Address - Phone:480-621-3505
Practice Address - Fax:480-621-3506
Is Sole Proprietor?:No
Enumeration Date:2014-12-01
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN137480163W00000X
AZTAP7716363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse