Healthcare Provider Details

I. General information

NPI: 1225693302
Provider Name (Legal Business Name): JULIE HURST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2019
Last Update Date: 07/01/2022
Certification Date: 07/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 K ST NW STE 600
WASHINGTON DC
20006-1051
US

IV. Provider business mailing address

2021 K ST NW STE 600
WASHINGTON DC
20006-1051
US

V. Phone/Fax

Practice location:
  • Phone: 202-888-8365
  • Fax: 833-200-5844
Mailing address:
  • Phone: 202-888-8365
  • Fax: 833-200-5844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: