Individual
JULIE E THORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
19503 LAKE CHARLES HWY STE B, DERIDDER, LA 70634-2322
(337) 221-0337
(337) 221-0367
Mailing address
19503 LAKE CHARLES HWY STE B, DERIDDER, LA 70634-2322
(337) 221-0337
(337) 221-0367
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
213743
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3158833
—
LA
01
—
5799107599
NATIONAL REGISTRY OF CERTIFIED MEDICAL EXAMINERS
LA
Enumeration date
07/22/2020
Last updated
06/23/2026
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