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General NPI Number Information
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NPI Number | 1770179343
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Entity Type | Individual
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Provider Name | JULIANNE WALTERS PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 12/17/2020
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 3803 W CHESTER PIKE STE 160
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073-2336
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Country | US
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Telephone | 484-337-1530
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Fax | 484-337-1412
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Provider Business Mailing Address
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Address Line | 3803 W CHESTER PIKE STE 160
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073-2336
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Country | US
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Telephone | 484-337-1530
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Fax | 484-337-1412
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP022563
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License Number State | PA
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