Individual
NYLA JEWELL GULLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1490 PARK AVE NW STE 4B, NORTON, VA 24273-1631
(276) 439-1463
(276) 439-1464
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 952-2111
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110011831
VA
363A00000X
Physician Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
0110011831
VA
Other
Enumeration date
02/24/2026
Last updated
07/02/2026
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