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NPI Code Detail

MEDICARE: JOY IVEY N.P.

MEDICARE: JOY IVEY N.P.
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
1164W00000XLicensed Practical NurseAPRN000947NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1LV462ZOTHERNVMEDICARE SMACC

General Provider Information

NPI Number : 1750374260
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOY IVEY N.P.
Provider Business Mailing Address
First Line : 10211 AUDOBON PEAK AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89166-5206
Country : US
Telephone Number : 805-757-4169
Fax Number :
Provider Business Practice Location Address
First Line : 8680 W CHEYENNE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-7458
Country : US
Telephone Number : 702-750-3422
Fax Number : 702-750-3434
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2005
Last Update Date : 01/17/2017

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