Provider Demographics
NPI:1548909187
Name:LARRICK, JULIE DAWN (RN)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:DAWN
Last Name:LARRICK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 CARPERS PIKE
Mailing Address - Street 2:
Mailing Address - City:HIGH VIEW
Mailing Address - State:WV
Mailing Address - Zip Code:26808-9562
Mailing Address - Country:US
Mailing Address - Phone:540-539-1218
Mailing Address - Fax:
Practice Address - Street 1:333 W CORK ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3870
Practice Address - Country:US
Practice Address - Phone:540-539-1218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA41115876364SH0200X
WV84187163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome Health
No163W00000XNursing Service ProvidersRegistered Nurse