Provider Demographics
NPI:1194245050
Name:MCMULLEN, JULEE ANN (DPT)
Entity type:Individual
Prefix:
First Name:JULEE
Middle Name:ANN
Last Name:MCMULLEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1923 N WEBB RD
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-3405
Mailing Address - Country:US
Mailing Address - Phone:316-262-4886
Mailing Address - Fax:316-262-4887
Practice Address - Street 1:1824 E JAMES ST
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:KS
Practice Address - Zip Code:67037-8634
Practice Address - Country:US
Practice Address - Phone:316-978-9000
Practice Address - Fax:316-978-9001
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-05653225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSPENDINGMedicaid