1427474485 NPI number — MRS. JOYCE ANN MALEY PROVIDER

Table of content: MRS. JOYCE ANN MALEY PROVIDER (NPI 1427474485)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427474485 NPI number — MRS. JOYCE ANN MALEY PROVIDER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MALEY
Provider First Name:
JOYCE
Provider Middle Name:
ANN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PROVIDER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427474485
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/31/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1036 2200TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
IOLA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66749-3085
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
620-365-6033
Provider Business Mailing Address Fax Number:
620-365-6033

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1036 2200TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IOLA
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66749-3085
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
620-365-6033
Provider Business Practice Location Address Fax Number:
620-365-6033
Provider Enumeration Date:
03/13/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 320900000X , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00101017490 , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com