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General NPI Number Information
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NPI Number | 1184626905
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Entity Type | Individual
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Provider Name | JULIE T TRICE CRNP
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Gender | Female
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Dates
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Enumeration Date | 08/11/2005
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Last Update Date | 03/03/2020
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Provider Practice Location Address
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Address Line | 3407 SHAMROCK CT
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City | GAUTIER
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State | MS
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Zip | 39553
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Country | US
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Telephone | 228-497-0690
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Fax | 228-497-1363
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Provider Business Mailing Address
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Address Line | 3929 AIRPORT BLVD STE 1-206
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City | MOBILE
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State | AL
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Zip | 36609-2233
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Country | US
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Telephone | 251-721-9649
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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 | 658766
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 1-053065
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License Number State | AL
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