Individual
DERA JOY HARVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
9333 E 21ST ST N, WICHITA, KS 67206-2927
(316) 634-4700
(316) 634-4770
Mailing address
1901 E 1ST ST; PO BOX 467, NEWTON, KS 67114-0467
(316) 284-6400
(316) 284-6490
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
13-116112-082
KS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
53-78225-082
KS
Other
Enumeration date
05/03/2018
Last updated
02/05/2020
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