Provider Demographics
NPI:1861631251
Name:TRAWICK, JULIE TINER (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:TINER
Last Name:TRAWICK
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:11045 COLUMBIA ROAD
Mailing Address - Street 2:
Mailing Address - City:BLAKELY
Mailing Address - State:GA
Mailing Address - Zip Code:39823
Mailing Address - Country:US
Mailing Address - Phone:229-723-4313
Mailing Address - Fax:229-723-3734
Practice Address - Street 1:11045 COLUMBIA ROAD
Practice Address - Street 2:
Practice Address - City:BLAKELY
Practice Address - State:GA
Practice Address - Zip Code:39823
Practice Address - Country:US
Practice Address - Phone:229-723-4313
Practice Address - Fax:229-723-3734
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-088780363L00000X
GARN131042363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner