Provider Demographics
NPI:1639904634
Name:GOMPERS, JULIA TAYLOR (FNP-BC)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:TAYLOR
Last Name:GOMPERS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:TAYLOR
Other - Last Name:PALMER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:8 LENOX AVE
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-5810
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8 LENOX AVE
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-5810
Practice Address - Country:US
Practice Address - Phone:304-231-7458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV118034363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily