360 Health Integrated Medical Boutique, PLLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

360 HEALTH INTEGRATED MEDICAL BOUTIQUE, PLLC

Practice address

1190 W Pioneer Pkwy
Arlington, TX 76013-6367

Phone

(682) 276-6595

Fax

(817) 583-6543

NPI assigned

Dec 30, 2019

Last updated

Feb 17, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Tracy Julien, FNP-CNPI 1417424219

Title

Family Nurse Practitioner

Phone

(504) 215-3919

Specialties & licenses 1

Addresses

Other names 1

• Weight Away Health and Wellness Former legal business name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tracy Julien, FNP

  • Nurse Practitioner
  • Arlington, TX
  • NPI 1417424219
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1577664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739750400000",
    "number": "1730728403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1190 W PIONEER PKWY",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760136367",
            "telephone_number": "682-276-6595",
            "fax_number": "817-583-6543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 W PIONEER PKWY",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760136367",
            "telephone_number": "682-276-6595",
            "fax_number": "817-583-6543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "360 HEALTH INTEGRATED MEDICAL BOUTIQUE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-30",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A",
        "authorized_official_last_name": "JULIEN",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "504-215-3919",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Weight Away Health and Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Weight Away Health and Wellness",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Family Nurse Practitioner in Arlington, TX
• Providers in Arlington, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.