Individual
MRS. KATHY JO JUSTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
495 EAST MAIN STREET, LEBANON, VA 24266-1100
(276) 889-3700
(276) 889-5505
Mailing address
PO BOX 2377, LEBANON, VA 24266-2377
(276) 889-3700
(276) 889-5505
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024166373
VA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
0024166373
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010261295
—
VA
05
—
1093796146
—
VA
Enumeration date
11/07/2005
Last updated
02/13/2017
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