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NPI Code Detail

MEDICARE: MRS. JULIE DIANE PAVEY N.P.

MEDICARE: MRS. JULIE DIANE PAVEY N.P.
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
1363LP0200XPediatric Nurse Practitioner0024164529VA

General Provider Information

NPI Number : 1720117021
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JULIE DIANE PAVEY N.P.
Provider Business Mailing Address
First Line : 8413 CHANDON CT
Second Line :
City : CHESTERFIELD
State : VA
Zip : 23838-5122
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2820 WATERFORD LAKE DR STE 102
Second Line :
City : MIDLOTHIAN
State : VA
Zip : 23112-3994
Country : US
Telephone Number : 804-372-3473
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2007
Last Update Date : 09/15/2025

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