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General NPI Number Information
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NPI Number | 1023813177
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Entity Type | Individual
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Provider Name | JULIA GRACE CYR NP
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Gender | Female
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Dates
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Enumeration Date | 02/13/2025
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 11921 FREEDOM DR STE 550
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City | RESTON
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State | VA
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Zip | 20190-5635
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Country | US
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Telephone | 703-783-4375
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Fax | 571-376-6564
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Provider Business Mailing Address
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Address Line | 11921 FREEDOM DR STE 550
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City | RESTON
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State | VA
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Zip | 20190-5635
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Country | US
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Telephone | 703-783-4375
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024192602
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License Number State | VA
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