Provider Demographics
NPI:1508490392
Name:MCVAY, JULIA JEAN (APRN, PMHNP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:JEAN
Last Name:MCVAY
Suffix:
Gender:F
Credentials:APRN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5545 N EDWARDS CIR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67204-5400
Mailing Address - Country:US
Mailing Address - Phone:316-680-7503
Mailing Address - Fax:
Practice Address - Street 1:5545 N EDWARDS CIR
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67204-5400
Practice Address - Country:US
Practice Address - Phone:316-680-7503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS122619163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Single Specialty