Healthcare Provider Details

I. General information

NPI: 1467077362
Provider Name (Legal Business Name): JULIA CHRISTIAN BAYS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2020
Last Update Date: 06/16/2020
Certification Date: 06/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 BROAD ST
SUMMERSVILLE WV
26651-1796
US

IV. Provider business mailing address

6805 WEBSTER RD
SUMMERSVILLE WV
26651-9332
US

V. Phone/Fax

Practice location:
  • Phone: 304-872-2090
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number64751
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: