Provider Demographics
NPI:1356691455
Name:AMANTEA, JULIA G (NP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:G
Last Name:AMANTEA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:E
Other - Last Name:GROFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:320 N 25TH ST APT D
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-7173
Mailing Address - Country:US
Mailing Address - Phone:540-239-5387
Mailing Address - Fax:
Practice Address - Street 1:1250 E MARSHALL ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5051
Practice Address - Country:US
Practice Address - Phone:540-239-5387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-16
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001229743163W00000X
VA0024170295363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse