Provider Demographics
NPI:1831955608
Name:LEAVITT, JULIE ANN (FNP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:LEAVITT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N VEITCH ST APT 504
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-5823
Mailing Address - Country:US
Mailing Address - Phone:540-905-1478
Mailing Address - Fax:
Practice Address - Street 1:1200 N VEITCH ST APT 504
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-5823
Practice Address - Country:US
Practice Address - Phone:540-905-1478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001275899163WM0102X
VA0024189175363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn