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General NPI Number Information
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NPI Number | 1164311205
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Entity Type | Individual
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Provider Name | JULIE M THOMAS PMNHP
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Gender | Female
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 149 JEFFERSON ST S STE A
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City | MONTICELLO
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State | MS
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Zip | 39654-9400
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Country | US
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Telephone | 601-393-1953
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Fax | 833-449-2018
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Provider Business Mailing Address
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Address Line | 2710 LEHMANN RD NW
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City | ROXIE
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State | MS
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Zip | 39661-7008
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Country | US
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Telephone | 601-303-0092
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Fax |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 869867
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License Number State | MS
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