Healthcare Provider Details

I. General information

NPI: 1043445992
Provider Name (Legal Business Name): DEBORAH ELAINE JOINER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2009
Last Update Date: 05/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 NORTH IRWIN ST.
DAYTON OH
45403
US

IV. Provider business mailing address

127 NORTH IRWIN ST
DAYTON OH
45403
US

V. Phone/Fax

Practice location:
  • Phone: 937-263-5388
  • Fax:
Mailing address:
  • Phone: 937-263-5388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number2798778
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: