MEDICARE: JULIE LEE DAMEUS

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	363LF0000X	Family Nurse Practitioner	LG-0013492	DE

General Provider Information

NPI Number	:	1972470342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE LEE DAMEUS

Provider Business Mailing Address
First Line	:	10871 BUSTLETON AVE # 148
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19116-3301
Country	:	US
Telephone Number	:	215-888-6991
Fax Number	:

Provider Business Practice Location Address
First Line	:	10871 BUSTLETON AVE # 148
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19116-3301
Country	:	US
Telephone Number	:	215-888-6991
Fax Number	:

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

Provider Enumeration Date	:	10/21/2025
Last Update Date	:	10/21/2025

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