Healthcare Provider Details

I. General information

NPI: 1275844904
Provider Name (Legal Business Name): JULIE MARIE REAUME MSN, NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2010
Last Update Date: 06/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 N INDIAN CANYON DR
PALM SPRINGS CA
92262-4872
US

IV. Provider business mailing address

1150 N INDIAN CANYON DR
PALM SPRINGS CA
92262-4872
US

V. Phone/Fax

Practice location:
  • Phone: 760-323-6430
  • Fax: 760-323-6333
Mailing address:
  • Phone: 760-323-6430
  • Fax: 760-323-6333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberPENDING
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: