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General NPI Number Information
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NPI Number | 1972046712
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Entity Type | Individual
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Provider Name | JULIE ELLAN ARCHIBALD
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Gender | Female
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Dates
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Enumeration Date | 11/28/2016
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 2401 E ST NW SA-1 COLUMBIA PLAZA SUITE L 201
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City | WASHINGTON
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State | DC
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Zip | 20522-9763
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Country | US
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Telephone | 202-663-1692
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Fax |
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Provider Business Mailing Address
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Address Line | 2230 ASTANA PLACE
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City | WASHINGTON
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State | DC
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Zip | 20521-2230
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Country | US
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Telephone |
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Fax | 901-457-0465
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 255233
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5009125
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | NP500023903
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License Number State | DC
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