Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 35396 | KY |
N | 207QA0401X | Family Doctor - Addiction Medicine | 35396 | KY |
N | 207QA0505X | Family Doctor - Adult Medicine | 35396 | KY |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 35396 | KY |
N | 207QS0010X | Family Doctor - Sports Medicine | 35396 | KY |
NPI | 1669416996 |
---|---|
Provider Name | Jennifer Marie Joyce |
First Address | Honesdale, PA 18431-2121 |
Second Address | Honesdale, PA 18431-2121 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 10/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64001746 | (05) | KY |
G00547 | (02) |