1881679850 NPI number — JOYE BETH OLDHAM FNP MSN APRN BC

Table of content: JOYE BETH OLDHAM FNP MSN APRN BC (NPI 1881679850)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881679850 NPI number — JOYE BETH OLDHAM FNP MSN APRN BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OLDHAM
Provider First Name:
JOYE
Provider Middle Name:
BETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP MSN APRN BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DYCUS
Provider Other First Name:
JOYE
Provider Other Middle Name:
BETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
APRN BC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1881679850
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/11/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 85
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DIXON SPRINGS
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37057-0085
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-374-3500
Provider Business Mailing Address Fax Number:
615-374-2244

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5 HIGHERS DRIVE
Provider Second Line Business Practice Location Address:
OLDHAM FAMILY CLINIC
Provider Business Practice Location Address City Name:
DIXON SPRINGS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37057-1215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
615-374-3500
Provider Business Practice Location Address Fax Number:
615-374-2244
Provider Enumeration Date:
12/13/2005

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: 363L00000X , with the licence number:  APN0000006655 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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