Provider Demographics
NPI:1114201365
Name:O'LEARY, JULIA ELAINE (APRN, FNP, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ELAINE
Last Name:O'LEARY
Suffix:
Gender:
Credentials:APRN, FNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6590 DAVID JAMES BLVD
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-6643
Mailing Address - Country:US
Mailing Address - Phone:775-502-0509
Mailing Address - Fax:775-258-0772
Practice Address - Street 1:1055 ROBERTA LN STE 103
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-2821
Practice Address - Country:US
Practice Address - Phone:775-502-0509
Practice Address - Fax:775-258-0772
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN001314363LF0000X
NVAPRN001314363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1114201365Medicaid