Provider Demographics
NPI:1790133957
Name:GRIECO, JULIE NICOLE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:NICOLE
Last Name:GRIECO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3099 COLLEGE PARK DR STE 109
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-8022
Mailing Address - Country:US
Mailing Address - Phone:832-998-7688
Mailing Address - Fax:
Practice Address - Street 1:3099 COLLEGE PARK DR STE 109
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-8022
Practice Address - Country:US
Practice Address - Phone:832-998-7688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-28
Last Update Date:2016-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2014015553363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily