Provider Demographics
NPI:1073273421
Name:MAGGARD, JOY LYNN (RRT)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:LYNN
Last Name:MAGGARD
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:944 MAPLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-5872
Mailing Address - Country:US
Mailing Address - Phone:734-787-2767
Mailing Address - Fax:
Practice Address - Street 1:944 MAPLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-5872
Practice Address - Country:US
Practice Address - Phone:734-787-2767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-27
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT22001227900000X
CORTL.0007299227900000X
UT12569690-5701227900000X
MI44010045402279C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care
No227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered