Provider Demographics
NPI:1972948719
Name:MCINTYRE, JULIE TUCKER (RN)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:TUCKER
Last Name:MCINTYRE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:INMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29349-7610
Mailing Address - Country:US
Mailing Address - Phone:864-316-9788
Mailing Address - Fax:864-249-1516
Practice Address - Street 1:6655 POTTERY RD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-6715
Practice Address - Country:US
Practice Address - Phone:864-316-9788
Practice Address - Fax:864-249-1516
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC54107163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool