Provider Demographics
NPI:1972560951
Name:THOMAS, JULIE HUFFMAN (NP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:HUFFMAN
Last Name:THOMAS
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 1:14729 ROAD C2
Mailing Address - Street 2:
Mailing Address - City:NEW BAVARIA
Mailing Address - State:OH
Mailing Address - Zip Code:43548
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 E RIVERVIEW AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545-9805
Practice Address - Country:US
Practice Address - Phone:419-592-8774
Practice Address - Fax:419-592-4103
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRNCNP05257363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2213170Medicaid
OHH446351Medicare PIN