Provider Demographics
NPI:1215262290
Name:THOMPSON, JULIE ANN (ADVCD(DONA); CLC)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:ADVCD(DONA); CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 566
Mailing Address - Street 2:
Mailing Address - City:RUSSELL
Mailing Address - State:PA
Mailing Address - Zip Code:16345-0566
Mailing Address - Country:US
Mailing Address - Phone:814-512-2718
Mailing Address - Fax:
Practice Address - Street 1:105 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:RUSSELL
Practice Address - State:PA
Practice Address - Zip Code:16345-1634
Practice Address - Country:US
Practice Address - Phone:814-512-2718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-09
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula