1518973064 NPI number — JOYCE ANN ALLEN APRN-FNP

Table of content: JOYCE ANN ALLEN APRN-FNP (NPI 1518973064)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518973064 NPI number — JOYCE ANN ALLEN APRN-FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALLEN
Provider First Name:
JOYCE
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN-FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SHEPHERD
Provider Other First Name:
JOYCE
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
ALLEN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1518973064
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/05/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
444 LEWIS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RICHMOND
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40475-7723
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-583-9275
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1306 VERSAILLES RD
Provider Second Line Business Practice Location Address:
STE 120
Provider Business Practice Location Address City Name:
LEXINGTON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40504-1796
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-259-2635
Provider Business Practice Location Address Fax Number:
859-254-7974
Provider Enumeration Date:
08/01/2006

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: 363LF0000X , with the licence number:  3003869 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 78008612 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3003869 . This is a "APRN LICENSE NUMBER" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 3869P . This is a "ARNP" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com