Provider Demographics
NPI:1841086808
Name:LAROSE, JULIANNA SHAYNE (PA-C)
Entity type:Individual
Prefix:
First Name:JULIANNA
Middle Name:SHAYNE
Last Name:LAROSE
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10187 PONDEROSA PINE CT
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-7904
Mailing Address - Country:US
Mailing Address - Phone:571-330-5728
Mailing Address - Fax:
Practice Address - Street 1:2151 OLD BRICK RD
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-5837
Practice Address - Country:US
Practice Address - Phone:804-727-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant