Provider Demographics
NPI:1710604806
Name:QUINN, JULIE ROMANOVICH (APRN-CNM)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ROMANOVICH
Last Name:QUINN
Suffix:
Gender:F
Credentials:APRN-CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:PALESTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75801-4781
Mailing Address - Country:US
Mailing Address - Phone:903-723-8554
Mailing Address - Fax:903-723-2054
Practice Address - Street 1:115 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:PALESTINE
Practice Address - State:TX
Practice Address - Zip Code:75801-4781
Practice Address - Country:US
Practice Address - Phone:903-723-8554
Practice Address - Fax:903-723-2054
Is Sole Proprietor?:No
Enumeration Date:2022-10-20
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1097186367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife