Healthcare Provider Details

I. General information

NPI: 1376514158
Provider Name (Legal Business Name): JULIE HOOKS CONWAY NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 N HOUSTON RD
WARNER ROBINS GA
31093-1505
US

IV. Provider business mailing address

907 CHAPEL RIDGE DR
PERRY GA
31069-2203
US

V. Phone/Fax

Practice location:
  • Phone: 478-922-9136
  • Fax: 478-923-6846
Mailing address:
  • Phone: 478-988-8201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN081259NP
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: