Provider Demographics
NPI:1740233618
Name:MCKINNIS, JULIA ANN (RN)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ANN
Last Name:MCKINNIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-3729
Mailing Address - Country:US
Mailing Address - Phone:434-770-8752
Mailing Address - Fax:434-836-3073
Practice Address - Street 1:1320 PINEY FOREST RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-1606
Practice Address - Country:US
Practice Address - Phone:434-836-3072
Practice Address - Fax:434-836-3073
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001136083163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator