Healthcare Provider Details

I. General information

NPI: 1013970417
Provider Name (Legal Business Name): JULIE ANN THOMPSON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2006
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 N MAIN ST
ROXBORO NC
27573-4755
US

IV. Provider business mailing address

1684 CUNNINGHAM RD
SEMORA NC
27343-9111
US

V. Phone/Fax

Practice location:
  • Phone: 336-599-9271
  • Fax:
Mailing address:
  • Phone: 336-504-3734
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201559
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024166162
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: