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General NPI Number Information
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NPI Number | 1851127617
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Entity Type | Individual
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Provider Name | JULIE EILEEN TYREE AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/10/2024
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Last Update Date | 10/04/2024
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Provider Practice Location Address
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Address Line | 110 EASTWOOD DR
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City | WALLACE
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State | NC
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Zip | 28466-9201
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Country | US
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Telephone | 910-285-2330
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Fax | 910-320-8429
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Provider Business Mailing Address
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Address Line | PO BOX 187
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City | FAISON
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State | NC
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Zip | 28341-0187
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Country | US
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Telephone | 910-267-2042
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Fax | 855-996-9090
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 371936
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 5020865
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 5020865
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License Number State | NC
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