MEDICARE: JULIE GAY LOUDAMY ACNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LC0200X	Critical Care Medicine Nurse Practitioner	509852	TX

General Provider Information

NPI Number	:	1417938937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE GAY LOUDAMY ACNP

Provider Business Mailing Address
First Line	:	PO BOX 18962
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-4084
Country	:	US
Telephone Number	:	800-566-5050
Fax Number	:	254-537-6869

Provider Business Practice Location Address
First Line	:	318 RICHLAND WEST CIR
Second Line	:	SUITE A
City	:	WACO
State	:	TX
Zip	:	76712-7919
Country	:	US
Telephone Number	:	254-537-6600
Fax Number	:	254-537-6601

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	01/06/2017

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