Healthcare Provider Details

I. General information

NPI: 1194303339
Provider Name (Legal Business Name): PAUL JOY FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 NOLAND RD
KANSAS CITY MO
64133-3685
US

IV. Provider business mailing address

4709 N 130TH ST
KANSAS CITY KS
66109-5501
US

V. Phone/Fax

Practice location:
  • Phone: 913-353-5757
  • Fax: 913-318-3327
Mailing address:
  • Phone: 913-669-9857
  • Fax: 913-318-3327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF03211263
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: