MEDICARE: JULIE ANN NEEFE FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	0024171625	VA

General Provider Information

NPI Number	:	1053739177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE ANN NEEFE FNP-BC

Provider Business Mailing Address
First Line	:	208 E PLUME ST
Second Line	:	SUITE 213
City	:	NORFOLK
State	:	VA
Zip	:	23510-1757
Country	:	US
Telephone Number	:	757-685-6157
Fax Number	:

Provider Business Practice Location Address
First Line	:	208 E PLUME ST
Second Line	:	SUITE 213
City	:	NORFOLK
State	:	VA
Zip	:	23510-1757
Country	:	US
Telephone Number	:	757-685-6157
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2014
Last Update Date	:	01/26/2015

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