Provider Demographics
NPI:1790886950
Name:STANLEY, JULIE R (ARNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:R
Last Name:STANLEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 SW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-1674
Mailing Address - Country:US
Mailing Address - Phone:785-295-8359
Mailing Address - Fax:785-231-5988
Practice Address - Street 1:1700 SW 7TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1674
Practice Address - Country:US
Practice Address - Phone:785-295-8359
Practice Address - Fax:785-231-5988
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS44797363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100361780DMedicaid
KS100361780DMedicaid
KSP09666Medicare UPIN