MEDICARE: MRS. JOYCE LEANN YOCK RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WP0807X	Child & Adolescent Psychiatric/Mental Health Registered Nurse		OR

General Provider Information

NPI Number	:	1780888735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JOYCE LEANN YOCK RN

Provider Business Mailing Address
First Line	:	209 CEDAR ST
Second Line	:
City	:	ADAIR VILLAGE
State	:	OR
Zip	:	97330-9438
Country	:	US
Telephone Number	:	541-745-5076
Fax Number	:

Provider Business Practice Location Address
First Line	:	209 CEDAR ST
Second Line	:
City	:	ADAIR VILLAGE
State	:	OR
Zip	:	97330-9438
Country	:	US
Telephone Number	:	503-234-9591
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2007
Last Update Date	:	07/08/2007

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