Provider Demographics
NPI:1912282674
Name:THOMPSON, JULIE PARKER (FNP-BC, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:PARKER
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:FNP-BC, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 UNION RD
Mailing Address - Street 2:STE B
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-5591
Mailing Address - Country:US
Mailing Address - Phone:704-864-8775
Mailing Address - Fax:980-225-0549
Practice Address - Street 1:1006 UNION RD
Practice Address - Street 2:STE B
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-5591
Practice Address - Country:US
Practice Address - Phone:704-864-8775
Practice Address - Fax:980-225-0549
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC180906363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7005683Medicaid
NC7005683Medicaid