Individual
MRS. JULIE ANN GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, RDH
Contact information
Practice address
60 CR 2323, SULPHUR SPRINGS, TX 75482
(682) 365-9615
Mailing address
60 CR 2323, SULPHUR SPRINGS, TX 75482
(682) 365-9615
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
805584
TX
Other
Enumeration date
09/14/2018
Last updated
09/14/2018
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