Individual
JULIE A SUITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
116 MIMOSA DR, THOMASVILLE, GA 31792-6605
(229) 584-5570
(229) 551-8697
Mailing address
116 MIMOSA DR, THOMASVILLE, GA 31792-6605
(229) 584-5570
(229) 551-8691
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN216275
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN216275
GA LICENSE
GA
Enumeration date
01/11/2019
Last updated
11/15/2023
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