Provider Demographics
NPI:1609547660
Name:MONTGOMERY, JULIA (DNP, FNP-BC, CCRN)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:DNP, FNP-BC, CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13541 E BOUNDARY RD STE 105
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-3942
Mailing Address - Country:US
Mailing Address - Phone:804-601-8625
Mailing Address - Fax:
Practice Address - Street 1:13541 E BOUNDARY RD STE 105
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112-3942
Practice Address - Country:US
Practice Address - Phone:804-601-8625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001235204163W00000X
VA0024182692363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse