JULIE R. STACKHOUSE

FORT WAYNE, IN
NPI1942352802
Former NameJULIE R. MITCHENER
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: IN  71001177A)
Additional Taxonomies367A00000X Advanced Practice Midwife
(Licence: IN  09000127A)
Enumeration Date2007-01-18
Last Update Date2020-01-30
Business Address
JULIE R. STACKHOUSE CNM
2414 E STATE BLVD SUITE 101
FORT WAYNE, IN 46805-4760
Phone number: 260-422-7455
Mailing Address
JULIE R. STACKHOUSE CNM
6920 POINTE INVERNESS WAY STE 200
FORT WAYNE, IN 46804-7934
Phone number: 260-479-3516