Provider Demographics
NPI:1922315787
Name:NIX, JULIE ANNE (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANNE
Last Name:NIX
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 S HIGHWAY 97
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-3832
Mailing Address - Country:US
Mailing Address - Phone:918-245-7373
Mailing Address - Fax:918-245-7374
Practice Address - Street 1:3801 S HIGHWAY 97
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-3832
Practice Address - Country:US
Practice Address - Phone:918-245-7373
Practice Address - Fax:918-245-7374
Is Sole Proprietor?:No
Enumeration Date:2010-08-31
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14717183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist