Provider Demographics
NPI:1245520626
Name:PURISIMA, JULIE (WHNP)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:
Last Name:PURISIMA
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 403744
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-3744
Mailing Address - Country:US
Mailing Address - Phone:804-231-9691
Mailing Address - Fax:804-231-2241
Practice Address - Street 1:7101 JAHNKE RD STE 1054
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4017
Practice Address - Country:US
Practice Address - Phone:804-231-9691
Practice Address - Fax:804-231-2241
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024169325363LX0001X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology