Healthcare Provider Details

I. General information

NPI: 1366843120
Provider Name (Legal Business Name): JULIA P. WETMORE CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2014
Last Update Date: 04/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4360 COUNTY HOME ROAD
CONOVER NC
28613
US

IV. Provider business mailing address

4360 COUNTY HOME ROAD
CONOVER NC
28613
US

V. Phone/Fax

Practice location:
  • Phone: 828-465-7668
  • Fax: 828-256-7711
Mailing address:
  • Phone: 828-465-7668
  • Fax: 828-256-7711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95986
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5007070
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: