Individual
JULIE T MASSOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
253 SAGAMORE PKWY W, WEST LAFAYETTE, IN 47906-1501
(812) 996-0323
(812) 996-0321
Mailing address
1200 W WHITE RIVER BLVD, MUNCIE, IN 47303-4988
(877) 668-5621
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
3010177
KY
363LF0000X
Family Nurse Practitioner
Primary
71006755A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300017189
—
IN
Enumeration date
12/13/2016
Last updated
02/01/2021
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