MEDICARE: MISS JOYCE OJEJE-ISAGBA APRN

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	10200055	FL

General Provider Information

NPI Number	:	1912595745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JOYCE OJEJE-ISAGBA APRN

Provider Business Mailing Address
First Line	:	36548 GRAND ISLAND OAKS CIR
Second Line	:
City	:	GRAND ISLAND
State	:	FL
Zip	:	32735-9644
Country	:	US
Telephone Number	:	352-446-6315
Fax Number	:

Provider Business Practice Location Address
First Line	:	1205 DR MARTIN L KING JR WAY
Second Line	:
City	:	HAINES CITY
State	:	FL
Zip	:	33844-3490
Country	:	US
Telephone Number	:	352-446-6315
Fax Number	:

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

Provider Enumeration Date	:	01/07/2021
Last Update Date	:	01/07/2021

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