Provider Demographics
NPI:1841210507
Name:DELL'ORSO, JULIE TAYLOR (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:TAYLOR
Last Name:DELL'ORSO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:T
Other - Last Name:GAUTIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26506-1200
Mailing Address - Country:US
Mailing Address - Phone:304-598-4800
Mailing Address - Fax:
Practice Address - Street 1:608 CHEAT RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-4210
Practice Address - Country:US
Practice Address - Phone:855-988-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN60310363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810006751Medicaid
WV2029061Medicare PIN