Provider Demographics
NPI:1023566908
Name:STAPLES, JULIETTE
Entity Type:Individual
Prefix:
First Name:JULIETTE
Middle Name:
Last Name:STAPLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JULIETTE
Other - Middle Name:
Other - Last Name:STAPLES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-C
Mailing Address - Street 1:6530 HULL STREET RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-2636
Mailing Address - Country:US
Mailing Address - Phone:804-674-3425
Mailing Address - Fax:804-554-5388
Practice Address - Street 1:6530 HULL STREET RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23224-2636
Practice Address - Country:US
Practice Address - Phone:804-674-3425
Practice Address - Fax:804-554-5388
Is Sole Proprietor?:No
Enumeration Date:2016-09-20
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024174011363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily