Provider Demographics
NPI:1891850731
Name:HOOKS, JULIE (NP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:HOOKS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1489 KENNEDY RD
Mailing Address - Street 2:
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31794-4159
Mailing Address - Country:US
Mailing Address - Phone:229-391-9931
Mailing Address - Fax:229-391-9961
Practice Address - Street 1:1489 KENNEDY RD
Practice Address - Street 2:
Practice Address - City:TIFTON
Practice Address - State:GA
Practice Address - Zip Code:31794-4159
Practice Address - Country:US
Practice Address - Phone:229-391-9931
Practice Address - Fax:229-391-9961
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2011-11-10
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2007-07-24
Provider Licenses
StateLicense IDTaxonomies
GAR118682363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00856974BMedicaid
GA00856974BMedicaid
GA50BBGJSMedicare ID - Type UnspecifiedMEDICARE PART B PROVIDER