=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972456747
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADVANCED PRACTICE PSYCHIATRIC, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/19/2026
-----------------------------------------------------
Last Update Date | 02/19/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 100 SPRINGBROOKE BLVD
-----------------------------------------------------
City | ASTON
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19014-3100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 484-318-3121
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 100 SPRINGBROOKE BLVD
-----------------------------------------------------
City | ASTON
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19014-3100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 484-318-3121
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PSYCHIATRIC MENTAL HEALTH NP
-----------------------------------------------------
Name | MRS. JULIANNE WALTERS
-----------------------------------------------------
Credential | CRNP, PMHNP-BC
-----------------------------------------------------
Telephone | 484-318-3121
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------