Healthcare Provider Details

I. General information

NPI: 1205593522
Provider Name (Legal Business Name): JULIANNE LESLIE LOUZONIS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2021
Last Update Date: 11/22/2021
Certification Date: 11/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 FRONT ROYAL PIKE
WINCHESTER VA
22602-7313
US

IV. Provider business mailing address

123 PYRAMID DR
WINCHESTER VA
22603-4871
US

V. Phone/Fax

Practice location:
  • Phone: 540-281-6383
  • Fax:
Mailing address:
  • Phone: 540-281-6383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number000112456
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: