Healthcare Provider Details

I. General information

NPI: 1073273421
Provider Name (Legal Business Name): JOY LYNN MAGGARD RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2021
Last Update Date: 12/27/2021
Certification Date: 12/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

944 MAPLEWOOD AVE
YPSILANTI MI
48198-5872
US

IV. Provider business mailing address

944 MAPLEWOOD AVE
YPSILANTI MI
48198-5872
US

V. Phone/Fax

Practice location:
  • Phone: 734-787-2767
  • Fax:
Mailing address:
  • Phone: 734-787-2767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRT22001
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRTL.0007299
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number12569690-5701
License Number StateUT
# 4
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License Number4401004540
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: