Provider Demographics
NPI:1730145202
Name:ARMISTEAD, JULIE A (RNC WHNP)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:A
Last Name:ARMISTEAD
Suffix:
Gender:F
Credentials:RNC WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 J D ANDERSON DR
Mailing Address - Street 2:SUITE 402
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-1238
Mailing Address - Country:US
Mailing Address - Phone:304-599-6811
Mailing Address - Fax:304-599-7159
Practice Address - Street 1:1000 J D ANDERSON DR
Practice Address - Street 2:SUITE 402
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-1238
Practice Address - Country:US
Practice Address - Phone:304-599-6811
Practice Address - Fax:304-599-7159
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV36450363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0092224000Medicaid
R35263Medicare UPIN
WVARNP00052Medicare ID - Type Unspecified