Provider Demographics
NPI:1023813177
Name:CYR, JULIA GRACE (NP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:GRACE
Last Name:CYR
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11921 FREEDOM DR STE 550
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5635
Mailing Address - Country:US
Mailing Address - Phone:703-783-4375
Mailing Address - Fax:
Practice Address - Street 1:11921 FREEDOM DR STE 550
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5635
Practice Address - Country:US
Practice Address - Phone:703-783-4375
Practice Address - Fax:571-376-6564
Is Sole Proprietor?:No
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024192602363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health