Provider Demographics
NPI:1982400875
Name:D'AMICO, JULIA MICHELE
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:MICHELE
Last Name:D'AMICO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7081 HIGHLAND AVE SW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44481-8633
Mailing Address - Country:US
Mailing Address - Phone:330-367-9258
Mailing Address - Fax:
Practice Address - Street 1:200 GARFIELD DR NE STE 1
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-5557
Practice Address - Country:US
Practice Address - Phone:330-372-1828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF10240474363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily