Provider Demographics
NPI:1134726177
Name:CODY, JULI ANN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:JULI
Middle Name:ANN
Last Name:CODY
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7008 DOUMMAR DR
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-4808
Mailing Address - Country:US
Mailing Address - Phone:757-510-0639
Mailing Address - Fax:
Practice Address - Street 1:6160 KEMPSVILLE CIR STE 302A
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3936
Practice Address - Country:US
Practice Address - Phone:757-627-7301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-02
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024180179363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024180179OtherVIRGINIA BOARD OF NURSING