Healthcare Provider Details

I. General information

NPI: 1063626067
Provider Name (Legal Business Name): JOYCE PATTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 29 12 ROAD
GRAND JUNCTION CO
81502-5033
US

IV. Provider business mailing address

510 29 12 ROAD
GRAND JUNCTION CO
81502-5033
US

V. Phone/Fax

Practice location:
  • Phone: 970-254-4103
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number170880
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: