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General NPI Number Information
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NPI Number | 1134781081
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Entity Type | Individual
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Provider Name | JULIE PICKENS
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Gender | Female
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Dates
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Enumeration Date | 07/01/2019
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Last Update Date | 04/09/2020
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Provider Practice Location Address
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Address Line | 1686 W US HIGHWAY 79
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City | BUFFALO
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State | TX
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Zip | 75831-3490
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Country | US
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Telephone | 903-322-1290
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Fax | 903-322-1304
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Provider Business Mailing Address
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Address Line | PO BOX M
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City | BUFFALO
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State | TX
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Zip | 75831-0317
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Country | US
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Telephone | 903-322-1290
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Fax | 903-322-1304
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F06191195
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License Number State | TX
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