Provider Demographics
NPI:1023378833
Name:DAMERON, JULIET (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JULIET
Middle Name:
Last Name:DAMERON
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:1601 OLDE WILLIAM STREET
Mailing Address - Street 2:SUITE B
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-5525
Mailing Address - Country:US
Mailing Address - Phone:540-371-4004
Mailing Address - Fax:540-371-6455
Practice Address - Street 1:1601 OLDE WILLIAM STREET
Practice Address - Street 2:SUITE B
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-5525
Practice Address - Country:US
Practice Address - Phone:540-371-4004
Practice Address - Fax:540-371-6455
Is Sole Proprietor?:No
Enumeration Date:2012-05-25
Last Update Date:2012-05-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0110002583363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant