Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 0024165453 | VA |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | ARNP 9324382 | FL |
NPI | 1023207297 |
---|---|
Provider Name | Juliet Fay |
First Address | Centreville, VA 20120-1900 |
Second Address | New Port Richey, FL 34652-4915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2007 |
Last Update Date | 12/04/2012 |