Healthcare Provider Details

I. General information

NPI: 1649138629
Provider Name (Legal Business Name): JULIANNE ALONSO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 PONDSEDGE CT
STAFFORD VA
22554-8504
US

IV. Provider business mailing address

4 PONDSEDGE CT
STAFFORD VA
22554-8504
US

V. Phone/Fax

Practice location:
  • Phone: 540-706-7203
  • Fax:
Mailing address:
  • Phone: 540-706-7203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LS0200X
TaxonomySchool Nurse Practitioner
License Number1319039
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: