MEDICARE: JULIANNA GOLDEN MARYNIUK RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	0001295461	VA
2	367500000X	Certified Registered Nurse Anesthetist	0024196177	VA

General Provider Information

NPI Number	:	1205542602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANNA GOLDEN MARYNIUK RN

Provider Business Mailing Address
First Line	:	1118 N 33RD ST
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23223-7738
Country	:	US
Telephone Number	:	713-702-9446
Fax Number	:

Provider Business Practice Location Address
First Line	:	1118 N 33RD ST
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23223-7738
Country	:	US
Telephone Number	:	713-702-9446
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2023
Last Update Date	:	02/12/2026

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