# BLUE WATER PSYCHIATRY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699448316
- **Authorized official:** JUSTIN MCKINLEY PMHNP-BC (NURSE PRACTITIONER)
- **Authorized official phone:** (602) 872-8243

## Contact information

- **Practice address:** 2491 E BOSTON ST, GILBERT, AZ 85295-2379
- **Practice address phone:** (602) 872-8243
- **Practice address fax:** (480) 631-0546
- **Mailing address:** 2491 E BOSTON ST, GILBERT, AZ 85295-2379
- **Mailing address phone:** (602) 872-8243
- **Mailing address fax:** (480) 631-0546

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/28/2021
- **Last updated:** 07/28/2021