Provider Demographics
NPI:1770587024
Name:JUST, GLORIA (NP, PHD, RN)
Entity type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:
Last Name:JUST
Suffix:
Gender:F
Credentials:NP, PHD, RN
Other - Prefix:MISS
Other - First Name:GLORIA
Other - Middle Name:
Other - Last Name:ULICKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:238 MEADOW POINT DR
Mailing Address - Street 2:
Mailing Address - City:MONETA
Mailing Address - State:VA
Mailing Address - Zip Code:24121-2603
Mailing Address - Country:US
Mailing Address - Phone:540-297-5174
Mailing Address - Fax:
Practice Address - Street 1:217 WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523
Practice Address - Country:US
Practice Address - Phone:540-586-3711
Practice Address - Fax:540-586-4666
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017137900363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health