Provider Demographics
NPI:1144880600
Name:FLANAGAN, JULIE ANNE (CNM)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:ANNE
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 SAM PERRY BLVD STE 401
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-4466
Mailing Address - Country:US
Mailing Address - Phone:410-693-5876
Mailing Address - Fax:
Practice Address - Street 1:1101 SAM PERRY BLVD STE 401
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4466
Practice Address - Country:US
Practice Address - Phone:540-940-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024177730367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife