Doctor Name: | JULIE T TRICE |
NPI Number: | 1184626905 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | 1-053065 |
Business Practice Address: | 3407 Shamrock Ct Gautier, MS - 395535337 |
Business Phone Number: | 2284970690 |
Business Fax Number: | 2284971363 |
Mailing Address: | 3407 Shamrock Ct, GAUTIER |
State: | MS |
Postal Code: | 395535337 |
Phone Number: | 2284970690 |
Fax Number: | 2284971363 |
NPI Enumeration Date: | 08/11/2005 |
NPI Last Update Date: | 10/12/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0808X |
License Number: | 1-053065 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |