Individual provider Active NPI

Julie Marie Ignace, FNP-C

  • Nurse Practitioner
  • Flagstaff, AZ
National Provider Identifier
1417471079
Registry record updated Mar 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP10375 Issued in AZ
Practice address
824 S San Francisco Street
Flagstaff, AZ 86011-3260
Phone
(928) 523-2131
NPI assigned
Jul 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP10375 AZ Primary

Addresses

Primary practice location

824 S San Francisco Street
Flagstaff, AZ 86011-3260

Mailing address

PO Box 2217
Flagstaff, AZ 86003-2217
Phone (928) 220-5063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180502002510 AZ Practitioner - Nurse Practitioner 8921362732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP10375AZMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Country Healthcare Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615593600000",
    "number": "1417471079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2217",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860032217",
            "telephone_number": "928-220-5063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 S SAN FRANCISCO STREET",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860113260",
            "telephone_number": "928-523-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGNACE",
        "first_name": "JULIE",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-26",
        "last_updated": "2021-03-13",
        "certification_date": "2021-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP10375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.