MEDICARE: JOYCE LYNN HALT NP

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	363LF0000X	Family Nurse Practitioner	349549	CA

General Provider Information

NPI Number	:	1568446631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOYCE LYNN HALT NP

Provider Business Mailing Address
First Line	:	2615 E CLINTON AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93703-2223
Country	:	US
Telephone Number	:	559-225-6100
Fax Number	:

Provider Business Practice Location Address
First Line	:	2615 E CLINTON AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93703-2223
Country	:	US
Telephone Number	:	559-225-6100
Fax Number	:

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

Provider Enumeration Date	:	12/02/2005
Last Update Date	:	07/24/2007

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