Provider Demographics
NPI:1932159647
Name:PATSELL, JULIA (FNP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:PATSELL
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 1:109 DEER RUN RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-2863
Mailing Address - Country:US
Mailing Address - Phone:434-791-0306
Mailing Address - Fax:434-791-0310
Practice Address - Street 1:700 24TH ST
Practice Address - Street 2:
Practice Address - City:FORT GREGG ADAMS
Practice Address - State:VA
Practice Address - Zip Code:23801-1716
Practice Address - Country:US
Practice Address - Phone:048-734-9125
Practice Address - Fax:434-791-0310
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017138495363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAMP1367209OtherDEA NUMBER