Provider Demographics
NPI:1790436293
Name:BANKHEAD, JULIANNA
Entity Type:Individual
Prefix:
First Name:JULIANNA
Middle Name:
Last Name:BANKHEAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JULIANNA
Other - Middle Name:
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19255 SPRING CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24211-6645
Mailing Address - Country:US
Mailing Address - Phone:276-608-5756
Mailing Address - Fax:
Practice Address - Street 1:245 NORTH ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24201-3274
Practice Address - Country:US
Practice Address - Phone:276-669-4711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-16
Last Update Date:2022-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist